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Asthma bronchiale und Analgetika-Intoleranz

  • F. W. Rieben

Zusammenfassung

Kurz nach Synthese der Acetylsalicylsäure (ASS) aus Salicylsäure und Essigsäure durch Hoffmann im Jahre 1897 und erfolgreicher klinischer Prüfung (1899) an Patienten mit Gelenkrheumatismus durch Whittauer, veröffentlichte im Jahre 1902 Hirschberg [34] in der Deutschen Medizinischen Wochenschrift die erste Mitteilung über Nebenwirkungen der Substanz. 1911 berichtete Gilbert [27] über einen Asthmapatienten, bei dem nach Einnahme von Aspirin eine Urtikaria und ein angioneurotisches Ödem auftraten. 1914 wurde von Reed [58] mitgeteilt, daß ein Patient auf Aspirin ein angioneurotisches Ödem und einen Asthma-Anfall bekam. 1919 veröffentlichte Cooke [14] die Ergebnisse klinischer Provokationsteste mit ASS. Von 15 Patienten mit bekannter ASS-Unverträglichkeit bekamen 9 nach Einnahme dieser Substanz einen Asthma-Anfall. Weltweit berühmt wurden die Untersuchungen von van Leeuwen [41] aus dem Jahre 1928, der unter 100 Patienten mit schwerem Asthma bronchiale durch orale Provokation mit ASS in 16% einen Asthma-Anfall auslösen konnte. Verschiedene Publikationen machten auf die Gefährlichkeit der oralen Provokationstestung bei entsprechender Anamnese aufmerksam. So sind in diesem Zusammenhang bislang 10 Todesfälle beschrieben [5, 18, 25, 40, 74, 92, 100], ein Asthmatiker verstarb nach der Gabe von nur 5 mg ASS [18]. Bereits 1922 vermuteten Widal u. Mitarb. [103], daß eine enge Beziehung zwischen Asthma bronchiale, Polyposis nasi und Aspirinintoleranz besteht. 1968 bezeichneten Samter u. Beers [64] die Trias Polyposis nasi, Asthma bronchiale und lebensbedrohliche Reaktionen auf Aspirin sogar als eine „Krankheitsentität“.

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