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Confirmation of allergic reaction to aspirin by skin test and CAST

Allergy to aspirin (ASA) may be presented clinically with symptoms of respiratory hypersensitivity, cutaneous hypersensitivity and, rarely, as a anaphylaxis. A common problem in practice is established a precise diagnosis of aspirin allergy, because the available diagnostic tests are not sensitive enough. For reliable defined hypersensitivity reactions to ASA we investigated the concordance between results obtained with skin scratch test (SCR) and cellular antigen stimulation test (CAST). The study group comprised 45 patients: 20 patients with urticaria and/or angioedema, 13 patients with atopic dermatitis, 7 patients with medicamentous exanthema and 5 patients with rhinitis. The skin scratch test with previously prepared aspirin concentration was performed. Sulfidoleukotrienes (sLT) production after in vitro peripheral blood leukocytes stimulation with aspirin was measured using CAST-ELISA. We found and Cast in 69% (31/45) of the patients. A negative SCR with positive CAST was found in 7% (3/45) of patients, and positive SCR with negative CAST was found in 24% (11/45) of patients. We conclude that although in some cases we detect discrepancy between. SCR and CAST these tests can be valuable help for diagnosing allergy to ASA.

Allergic reaction; aspirin skin test; celular antigen stimulation test

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