ASPIRIN DESENSITIZATION "CUTTING-EDGE" TREATMENT FOR ALLERGIES

Like many Mississippians, Sebrana Weathersby, a nurse in pediatric infectious disease, suffers from severe sinusitis. Her allergies and sinus problems were always bad, but after giving birth to her second child, her symptoms got even worse. 

Until now, Weathersby thought she had tried everything to rid her of her problem. Two sinus surgeries later, she still suffered.

“The sinus surgeries did not prevent me from getting reoccurring polyps,” she said. 

Enter Dr. Gailen D. Marshall, professor of medicine and director of the Division of Allergy and Immunology, and colleagues at the UMC Allergy-Immunology Clinic who have just implemented a new program for patients with chronic sinusitis and nasal polyps.

“Chronic sinusitis is a common problem, but it is a common problem that is very difficult to treat – it can be because of allergies or other forms of inflammatory diseases,” Marshall said. “Cystic fibrosis can cause this problem and there also is a surprisingly high percentage of people who have sinus problems with aspirin.

“There is evidence that these individuals will have growth of their polyps related to taking aspirin or aspirin-like compounds such as ibuprofen.” 

Marshall plans to treat Weathersby with a procedure called aspirin desensitization. He will give her increasing doses of aspirin to impede the reaction she gets in her nose. She will then take two aspirins every day for the foreseeable future.

Weathersby also has asthma, a symptom that intensifies with the aspirin allergy.

“The systemic steroid treatment only works for a short while,” he said. “She can have her polyps taken out surgically, but the surgeons can only do that so many times. They can’t keep doing it over and over again. After two or three times, it becomes progressively more dangerous to continue to take them out.”

The desensitization procedure is a safe and effective way to minimize or eliminate problems with polyps and asthma related to aspirin ingestion.

The process to desensitize can take anywhere from one to three days, according to Marshall, who plans to do the procedure in his office rather than what most medical centers throughout the United States normally do.

“It turns out that until fairly recently, the only way you could desensitize someone to aspirin was to give them increasing doses in a hospital setting, actually in an intensive care setting,” Marshall said. “It can be quite expensive.”

Aspirin desensitization procedures began 10-15 years ago, but prior to Marshall and his colleagues, patients who needed this aspirin desensitization had to go to the Scripps Clinic in California.

“With a high level of success, now these people can be safely desensitized in an office setting,” he said. 

The patient is given tiny doses of aspirin early in the morning. Throughout the day, the aspirin dosage is increased. 

“We will give them the medication until they have an adverse reaction or until they get to the top dose for the day,” Marshall said. “If they have a problem, we take care of them in the office and they come back the next morning to complete the desensitization.”

The Medical Center’s clinic is the only allergy center in this part of the country to have an office-type setting for this procedure.

Marshall and his colleagues decided to offer this service because they believed it was something their patients needed.

“There are a lot of patients in our area that have this problem,” he said. “It is clinical cutting-edge medicine and it is certainly something that we in the UMC allergy-immunology service want to be able to offer.”

If someone thinks he or she might have either aspirin-sensitive asthma or nasal polyps, he or she can be referred to the clinic or can make an appointment to be assessed.

The perfect candidate is someone who has severe nasal polyps or knows that when he or she takes aspirin or an aspirin-like compound such as ibuprofen, it increases his or her respiratory difficulty.

Marshall said the success rate for these procedures is very high.

“My colleague in California has done almost 500 people this way and has always been able to desensitize. His success rate is 100 percent.”

—Jenny Woodruff (7-23-07)

2007-07-20 00:00:00 17133