Nonsteroidal Anti-inflammatory Drug Hypersensitivity and Sinus Disease View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

2014

AUTHORS

Jinny E. Chang , Andrew A. White , Ronald A. Simon

ABSTRACT

Aspirin-exacerbated respiratory disease is defined by concurrent chronic rhinosinusitis, nasal polyposis, asthma, and aspirin sensitivity. Clinical presentation includes symptoms of chronic sinus disease with nasal polyposis and asthma evolving over time with aspirin sensitivity occurring at any time in the course of disease. The aspirin reaction can involve both upper and lower airway reactions including naso-ocular reactions as well as shortness of breath from laryngospasm and/or bronchospasm. Both asthma and chronic rhinosinusitis symptoms are worse in patients with AERD, and anosmia is a frequent complaint. The pathogenesis of AERD is not yet clear; however, aspirin and other NSAIDs are nonselective inhibitors that shunt the arachidonic acid metabolism. The interplay of proinflammatory metabolites such as leukotrienes and decrease in inflammatory suppressors such as PGE2 may play a role. The reaction to aspirin in AERD is not an IgE-mediated reaction. Clinical diagnosis of presumed aspirin-exacerbated respiratory disease can be made without aspirin challenge; however, aspirin challenge is the gold standard for diagnosis of AERD. Patients with presumed disease should avoid all COX-1 inhibitors but can tolerate COX-2 inhibitors. Treatment in AERD includes management of each of the disease components of the syndrome. Aspirin desensitization allows patients to tolerate aspirin and other NSAIDs. Daily administration of aspirin following aspirin desensitization can improve AERD symptoms (including sense of smell) as well as aid in controlling asthma and nasal polyposis leading to overall management benefits with decreased polyp and sinus surgeries and systemic steroid use. More... »

PAGES

195-207

References to SciGraph publications

  • 2010-05. Rhinosinusitis and Asthma: A Link for Asthma Severity in CURRENT ALLERGY AND ASTHMA REPORTS
  • Book

    TITLE

    Diseases of the Sinuses

    ISBN

    978-1-4939-0264-4
    978-1-4939-0265-1

    Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/978-1-4939-0265-1_12

    DOI

    http://dx.doi.org/10.1007/978-1-4939-0265-1_12

    DIMENSIONS

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