ORIGINAL
ASA-augmentation in relation to ASA-intolerance
Original Ar ticle
1000 mg ASA. It is unclear whether higher doses of
ASA might indeed cause an outbreak of urticaria.
postulated that ASA opens some pathway that may
lead to an urticarial allergic reaction.
Under the influence of ASA an augmentation
of the reaction to a hypothetic allergen may occur,
such that an urticarial reaction can develop (Fig. 2).
Schliz et al [15] offered another possibility. They
The mechanism of ASA-intolerance remains
elusive. Present knowledge speaks for an indirect
participation of ASA in the reaction rather than for
a genuine allergy to ASA or its metabolites.
References
1. Abrishami MA, Thomas J. Aspirin intolerance – A review.
Ann Allergy 1977; 39: 28–37.
13. Rieger-Ziegler V, Kränke B, Aberer W. Vergleich der
Wertigkeit von In-vitro-Diagnostik, Hauttest und oralem
Provokationstest bei Patienten mit Überempfindlichkeit
auf Acetylsalizylsäure. Allergologie 1999; 22: 645–9.
14. Samter M, Beers RF. Intolerance to aspirin. Clinical
studies and consideration of its pathogenesis. Ann Inter
Med 1968; 68: 975–83.
2. Busse A, Czech W, Schöpf E, Simon JC. Der CAST-ELISA in
der Diagnostik von pseudoallergischen Reaktionen
gegen Nahrungsmitteladditiva und Acetylsalicylsäure.
Allergologie 2000; 23: 110–5.
3. Cant AJ, Gibson P, Dancy M. Food hypersensitivity made
life threatening anaphylaxis by ingestion of aspirin. Brit
Med J 1984; 288: 755–6.
15. Schliz M, Rauterberg A, Jung EG. Nahrungsmittel-
abhängige anstrengungsinduzierte Anaphylaxie.
Akt Dermatologie 1995; 21: 264.
4. Davidson AE, Passero MA, Settipane GA. Buckwheat-
induced anaphylaxis: a case report. Ann Allergy 1992; 69:
439–40.
16. Schlumberger HD. Drug-induced pseudoallergic syn-
drome as exemplified by acetylsalicylic acid intolerance.
In: Dukor P, Kallós P, Schlumberger HD, West GB, eds.
Pseudo-allergic reaction. Involvement of drugs and
chemicals. Basel: Karger 1980: 125–203.
5. Flemström G, Marsden NV, Richter W. Passive cutaneous
anaphylaxis in guinea pigs elicited by gastric absorption
of dextran induced by acetylsalicylic acid. Int Archs
Allergy appl Immun 1976; 51: 627–36.
17. Szczeklik A, Stevenson DD. Aspirin-induced asthma:
Advances in pathogenesis and management J Allergy
Clin Immunol 1999; 104:5–13.
6. Illig L. Urticaria und „Aspirin Intoleranz“ – Teilkomplex
eines fächerübergreifenden pathogenetischen Prinzips?
Z Hautkr 1981; 56:347–67.
18. Wedi B, Elsner J, Kapp A. In vitro diagnostics of pseudo-
allergic reactions – new aspects. Allergy Clin Immunol
Int 1996; 8: 113–5.
7. Juhlin L, Michaelson G, Zetterström O. Urticaria and
asthma induced by food and drug additives in patients
with aspirin hypersensitivity. J Allergy Clin Immunol
1972; 50: 92–8.
19. Weltmann JK, Szaro RP, Settipane GA. An analysis of the
role of IgE in intolerance to Aspirin and Tartrazine.
Allergy 1978; 34: 273–81.
8. Krilis S, Gregson RP, Basten A, Boldo BA. Investigation of
the possible involvement of IgE anti-salizyloyl antibodies
in patients with urticaria. Int Archs Allergy appl Immun
1981; 64: 293–301.
20. Werfel T, Wedi B, Kleine-Tebbe J, Niggemann B, Saloga J,
Sennekamp J, Vieluf J, Vieths S, Zuberbier T, Jäger L. Vor-
gehen bei Verdacht auf eine pseudo-allergische Reaktion
durch Nahrungsmittelinhaltsstoffe. Gemeinsames Posi-
tionspapier von DGAI und ÄDA. Allergologie 2000; 23:
572–9.
9. Möller R, Paul E. Acetylsalicylsäure als Augmentations-
faktor einer Nahrungsmittel-Allergie. Hautarzt 1996; 47:
281–3.
10. Ohnishi-lnoue Y, Mitsuya K, Horio T. Aspirin-sensitive
urticaria: provocation with a leukotriene receptor anta-
gonist. Br J Derm 1998; 138: 483–5.
21. Zuberbier T, Chantraine-Hess S, Hartmann K, Czarnetzki
BM. Pseudoallergen-free diet in the treatment of chronic
urticaria. Acta Derm Venereol 1995; 75: 484–7.
11. Paul E, Gall HM, Müller I, Möller R. Dramatic augmenta-
tion of a food allergy by acetylsalicylic acid. J Allergy Clin
Immunol 2000; 105: 844.
Prof. Dr. Eberhard Paul
Hautklinik am Klinikum Nürnberg-Nord, Akademi-
sches Lehrkrankenhaus der Friedrich-Alexander-Uni-
versität, Prof.-Ernst-Nathan-Str. 1, D-90410 Nürnberg
12. Paul E, Geipel M, Möller R. Katamnestische Unter-
suchungen an Patienten mit chronischer Urticaria und
ASS-Intoleranz. Hautarzt 1994; 45: 12–4.
Allergo J 2001; 10: 269–72
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