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Aspirin desensitization, cardiac disease

Question:

6/4/2018
I have a patient with history of IgE mediated aspirin allergy 20 years ago. He is requiring heart catherization and cardiology would like him to be desensitized to aspirin. Question 1. Is pretreatment with antihistamine and singulair recommended? Question 2. Patient requires pretreatment with prednisone due to contrast allergy for the catherization which will follow the desensitization. Do you think it is reasonable to do desensitization if on prednisone?

Answer:

I assume by aspirin allergy this does not mean AERD, if that is the case then premedication with antihistamines and LTRA's is not part of the protocols that I have used. My experience with cardiology and these patients is that they need the ASA immediately after the cardiac procedure.

I hope this has been helpful

Andrew Murphy, MD