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Free Content Para-aminosalicylic acid (PAS) desensitization review in a case of multidrug-resistant pulmonary tuberculosis [Case Study]

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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.
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Keywords: desensitization; hypersensitivity; multidrug-resistant tuberculosis; para-aminosalicylic acid

Document Type: Short Communication

Affiliations: 1: Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA 2: Indianapolis Allergy & Asthma Physicians, Indianapolis, Indiana, USA 3: Division of Allergy & Immunology, Mayo Clinic, Rochester, Minnesota, USA

Publication date: May 1, 2003

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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