Para-aminosalicylic acid (PAS) desensitization review in a case of multidrug-resistant pulmonary tuberculosis.

Abstract

SETTING:

Tertiary care hospital in the Upper Midwest, United States.

OBJECTIVE:

Rapid desensitization to para-aminosalicylic acid (PAS) in a patient with previous hypersensitivity reaction and a review of published PAS desensitization protocols.

DESIGN:

Composition and implementation of a short-course PAS desensitization protocol for a 34-year-old woman with multidrug-resistant (MDR) pulmonary tuberculosis, incorporating published experiences of PAS desensitization over the past 50 years.

RESULTS:

We composed a protocol and successfully desensitized our patient to PAS (Paser granules). By starting with a low dose (50 mg), then doubling the PAS dose on each successive day, our patient was able to tolerate full dose in 1 week. No steroids were required and no adverse reactions were encountered. Previous published PAS desensitization protocols used starting doses of 10-500 mg, desensitization time ranges from 7 to 54 days and commonly used steroids or corticotropin.

CONCLUSION:

Rapid desensitization to PAS can be successfully conducted within 1 week without the use of steroids or corticotropin. Given the limited number of drugs available for many patients with MDR-TB, desensitization to PAS is a valid alternative to drug discontinuation for patients with hypersensitivity reactions.

• Authors: J W Wilson, P Kelkar, E Frigas
• Journal: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease (Int J Tuberc Lung Dis) Vol. 7 Issue 5 Pg. 493-7 (May 2003) ISSN: 1027-3719 [Print] France
• PMID: 12757053 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antitubercular Agents
• Aminosalicylic Acid

Topics

• Adult
• Aminosalicylic Acid (administration & dosage, immunology)
• Antitubercular Agents (administration & dosage, immunology)
• Desensitization, Immunologic
• Female
• Humans
• Tuberculosis, Multidrug-Resistant (drug therapy, immunology)
• Tuberculosis, Pulmonary (drug therapy, immunology)