The Impact of Parasite Infection Associated With Hyper-IgE on Tolerance of Aspirin and Desensitization

Abstract

A Y 892 The Impact of Parasite Infection Associated With Hyper-IgE on Tolerance of Aspirin and Desensitization N. V. Dinh, C. C. Hieu, N. V. Doan, S. van Nunen, T. Craig; Allergy Department, Hanoi Medical University, Hanoi, VIET NAM, Department of Allergy, Royal North Shore Hospital and Sydney Medical SchoolNorthern, University of Sydney, Sydney, AUSTRALIA, Penn State University, Hershey, PA. RATIONALE: Parasites are highly prevalent worldwide particularly in underdeveloped regions including Vietnam. Hyper-IgE may be a consequence of parasite infection. Presently, it is unknown how parasite infestation associated with Hyper-IgE affects ASA sensitivity and desensitization. METHOD: The patient was a 76-year-oldVietnamesemalewith coronary artery disease requiring a stent, which necessitated aspirin. Urticaria complicated the use of aspirin and prevented a trial to desensitize the patient. At the same time the patient was found to have an IgE of 1337 IU/L and parasite infestationwith Lumbricoides, Toxocara and Liver fluke. ASA desensitization was re-attempted after treatment with abendazole. RESULTS: The second aspirin desensitization was successful without the complication of urticaria; however, the IgE level persisted over 1000 IU/L. The patient has been able to tolerate aspirin on a regular basis after treatment of his parasite infection. Our report documents a safe and successful desensitization to aspirin in an individual with hyper IgE caused by helmithic parasite infection who had recurrent urticaria whenever aspirinwas introduced; however, after treatment of his parasite infection he was able to tolerate repeat desensitization with aspirin and continued aspirin use. CONCLUSIONS: The combination of parasite infection and use of aspirin resulted in urticaria and inhibited attempts to desensitize the patient to aspirin. Treatment of the parasite infection allowed aspirin desensitization to be successful and the continued use of aspirin to be tolerated.