Aspirin-induced asthma (AIA) is a form of asthma caused by aspirin and some other medications. It occurs in individuals with sensitivities to aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and rarely, paracetamol. It is also called NSAID-induced asthma and aspirin-intolerant asthma and is in the spectrum of diseases called aspirin-exacerbated respiratory diseases.
Aspirin-induced asthma contributes to up to 20% of adult asthma cases. The condition is characterized by persistent rhinitis, asthma, aspirin intolerance, and nasal polyps. Diagnosis is based on these clinical findings with provocation testing done for confirmation. Treatment generally consists of avoiding NSAIDs. Desensitization may be employed in patients who must continue taking these medications.
Epidemiology
editAccording to a systematic review of the literature in 2004, the prevalence of AIA among adult asthmatics is 21%, and 5% in children with asthma.[1] Females are more commonly affected than males.[2]
Pathophysiology
editThe mechanisms by which NSAIDs induce asthma in susceptible individuals are currently unknown. Several hypotheses exist; the two most popular are the COX-1 theory and [3]
Cross sensitivity
edit| Medication | Incidence |
|---|---|
| Naproxen | 100% |
| Ibuprofen | 98% |
| Diclofenac | 93% |
| Paracetamol | 7% |
Individuals with AIA are frequently sensitive to not only aspirin, but to other nonsteroidal anti-inflammatory drugs (NSAIDs) as well, including ibuprofen, naproxen, and diclofenac.[1] There is considerably less cross sensitivity to paracetamol.[1]
Signs and symptoms
editThe clinical course of patients with AIA appears to follow a predictable course, progressing from persistent rhinitis, followed by asthma, aspirin intolerance, and the development of nasal polyps.[2] The first episode of aspirin-induced asthma most commonly develops following an upper respiratory infection.[2]
Diagnosis
editProvocation testing.[4]
Treatment
editAIA is difficult to treat.[5]
See also
edithttp://www.ncbi.nlm.nih.gov/pubmed/?term=arun+narayanankutty==References==
- ^ a b c d Jenkins C, Costello J, Hodge L (February 2004). "Systematic review of prevalence of aspirin induced asthma and its implications for clinical practice". BMJ. 328 (7437): 434. doi:10.1136/bmj.328.7437.434. PMC 344260. PMID 14976098.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ a b c Szczeklik A, Nizankowska E, Duplaga M (September 2000). "Natural history of aspirin-induced asthma. AIANE Investigators. European Network on Aspirin-Induced Asthma". Eur. Respir. J. 16 (3): 432–6. doi:10.1034/j.1399-3003.2000.016003432.x. PMID 11028656.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ Cite error: The named reference
pmid23246457was invoked but never defined (see the help page). - ^ Nizankowska E, Bestyńska-Krypel A, Cmiel A, Szczeklik A (May 2000). "Oral and bronchial provocation tests with aspirin for diagnosis of aspirin-induced asthma". Eur. Respir. J. 15 (5): 863–9. doi:10.1034/j.1399-3003.2000.15e09.x. PMID 10853850.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ Currie GP, Douglas JG, Heaney LG (2009). "Difficult to treat asthma in adults". BMJ. 338: b494. doi:10.1136/bmj.b494. PMID 19240094.
{{cite journal}}: CS1 maint: multiple names: authors list (link)
To combine
edit- http://thorax.bmj.com/cgi/content/full/55/suppl_2/S42#B9
- http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WH4-4JX9J7J-V&_user=1563816&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000053744&_version=1&_urlVersion=0&_userid=1563816&md5=40061280b46944a3df3cf47067dc0069
- http://www.ncbi.nlm.nih.gov/pubmed/17650824?ordinalpos=16&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
- http://www.ncbi.nlm.nih.gov/pubmed/16670507?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=5&log$=relatedreviews&logdbfrom=pubmed
- http://www.ncbi.nlm.nih.gov/pubmed/16670507?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=5&log$=relatedreviews&logdbfrom=pubmed
- http://www3.interscience.wiley.com/cgi-bin/fulltext/72513805/PDFSTART
- ^ Narayanankutty, A.; Reséndiz-Hernández, J. M.; Falfán-Valencia, R.; Teran, L. M. (2013 May). "Biochemical pathogenesis of aspirin exacerbated respiratory disease (AERD)". Clinical Biochemistry. 46 (7–8): 566–78. doi:10.1016/j.clinbiochem.2012.12.005. PMID 23246457.
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