No abstract

We recently observed a comparable patient who initially presented with NSAID hypersensitivity, developed chronic urticaria 4 years later and eventually lost both conditions after eradication of the intestinal protozoan Blastocystis hominis. 3 ASA hypersensitivity preceding the development of chronic urticaria has been reported by others, but a possible association of these conditions with infectious triggers was not assessed. 4 In some food-allergic patients, systemic immediate type reactions develop only when they are exposed to the respective allergen and concomitantly to ASA. 5 It can be speculated that here the allergic reaction is enhanced by pharmacologic actions of the NSAID (e.g. by an increase of intestinal antigen absorption or by facilitated mediator release). Transferring this to our patient, NSAIDs might have enhanced a subthreshold reaction to antigens from H. pylori, thus leading to clinical symptoms.