Aspirin is a common anti-inflammatory medication used to treat pain and is also used to decrease the risk of heart attacks and stroke in susceptible patients. While it is an extremely common medication, some patients do develop allergies or sensitivities to aspirin and other non-steroidal anti-inflammatory agents (NSAIDs). While aspirin sensitivity and aspirin allergy have different mechanisms of action, the symptoms that result are extremely similar.
Significance
Aspirin can be used to relieve symptoms of inflammatory diseases and is an extremely effective anti-inflammatory. It is commonly used to reduce fever and to relieve pain from headaches, menstrual cramps and muscle aches. It works by reducing the production of substances in the body that promote fever, pain, swelling and blood clots. Aspirin is also prescribed to patients who have had a heart attack or ischemic stroke or who are at high risk for these disorders. While there are other medications that can be used to treat these issues, aspirin is a commonly prescribed and utilized medication. For this reason, treatment of aspirin allergy is particularly important.
Symptoms
Symptoms of aspirin allergy and sensitivity are extremely similar. Patients may notice itchy eyes and rash, nasal congestion, difficulty breathing, hives, cough, dizziness or loss of consciousness. These symptoms typically occur within one hour from the time the medication is ingested. While some patients may develop mild symptoms with skin involvement only, other patients may develop more systemic symptoms. If a patient has any of these symptoms while taking aspirin, he should be evaluated by an allergist for potential aspirin allergy.
Types
There are several types of aspirin allergy. One type is a true allergy to aspirin alone. Patients with aspirin allergy develop symptoms of hives, cough, shortness of breath, vomiting or dizziness within an hour of taking aspirin. For these patients, taking other NSAIDs does not precipitate this response. Another type of allergy to aspirin is a class-related allergy. A patient with this allergy is allergic to all NSAIDs and will develop a similar reaction with any NSAID. Finally, a patient may have a non-allergic aspirin sensitivity. This reaction is very similar to that of an aspirin allergy, but is unlikely to progress to anaphylaxis, which is a life threatening allergic reaction. This sensitivity is often associated with asthma and nasal polyps. Patients with this disorder need to avoid all NSAIDs.
Identification
Allergy testing to aspirin can be performed in an allergist's office. Often, a patient's clinical history will be sufficient to diagnose an allergy to aspirin. While there is no standardized testing for aspirin allergy, an allergist may create a test by scratching the surface of the skin with a small amount of the medication and measuring any reaction that results. If the physician feels that the diagnosis of aspirin allergy is uncertain, the patient may be given small doses of the medication during an office visit and then be monitored for any reaction.
Treatment
For most patients with an allergy to aspirin, the most effective treatment is avoidance of the medication. In patients with nasal polyps and asthma, aspirin desensitization can be helpful. Desensitization is a process in which the patient takes a small amount of aspirin daily and then builds up to a regular dose. Once a patient is desensitized, he must take the medication daily. If the medication is not taken on a daily basis, the patient will likely have a reaction again.
