Aspirin-Induced and Intrinsic Asthma

  • D. A. Mathison
  • R. A. Simon
  • D. D. Stevenson
Conference paper

Abstract

Asthma is a syndrome characterized by increased responsiveness of the trachea and bronchi to various stimuli and manifested by widespread hyperreactivity of the airways that changes in severity either spontaneously or as a result of therapy. The increased responsiveness can be documented and the diagnosis confirmed by spirometric measurements of bronchodilatation following inhalations of beta-adrenergic drugs or broncho-constriction following inhalations of methacholine or histamine or exercise. When the asthmatic patient has attacks precipitated by exposures to aeroallergens to which he has IgE antibodies, the asthma is turned “allergic”, “atopic” or “extrinsic”; however, most of such patients also have the bronchospasticity “intrinsic” to the disease.

One subset of asthmatic patients has syndrome of chronic hyperplastic and eosinophilic rhinosinusitis with polyp formation and acute and severe rhinitic and asthmatic reaction to ingestion of ordinary doses of aspirin and aspirin-like non-steroidal antiinflammatory drugs (NSAID). Even though these patients avoid NSAID, their disease is progressive and frequently requires corticosteroid treatment for control. Cautions challenges in a hospital setting, beginning with 3 mg of aspirin and increasing doses at 2–3 hour intervals while monitoring spirometric function, may be undertaken to confirm sensitivity and repetitively to desensitize a patient who has need to take NSAID. Desensitization followed by continued daily NSAID treatment reduces the respiratory disease in some patients but not of sufficient degree to ordinarily warrant such treatment.

Keywords

Ozone Flare Prostaglandin Indomethacin Advil 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • D. A. Mathison
    • 1
  • R. A. Simon
    • 1
  • D. D. Stevenson
    • 1
  1. 1.Division of Allergy & Immunology and Department of Basic & Clinical ResearchScripps Clinic & Research FoundationLa JollaUSA

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