Clinical and pathologic perspectives on aspirin sensitivity and asthma.

Division of Allergy, Asthma and Immunology and the Department of Medicine, Scripps Clinic and the Scripps Research Institute, La Jolla, USA. dstevemd@AOL.com

The Journal of allergy and clinical immunology 2006 Oct

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Aspirin and other nonsteroidal anti-inflammatory drugs that inhibit COX-1 induce unique nonallergic reactions, consisting of attacks of rhinitis and asthma. These hypersensitivity reactions occur in a subset of asthmatic subjects, thus identifying them as having this exclusive clinical presentation. We refer to these patients as having aspirin-exacerbated respiratory disease, a disease process that produces devastating eosinophilic inflammation of both the upper and lower respiratory tracts. This review focuses on a description of patients with aspirin-exacerbated respiratory disease, methods available to diagnose their condition, the unique ability of all nonsteroidal anti-inflammatory drugs that inhibit COX-1 to cross-react with aspirin, an update on pathogenesis, and current thoughts about treatment.

Citation

Donald D Stevenson, Andrew Szczeklik. Clinical and pathologic perspectives on aspirin sensitivity and asthma. The Journal of allergy and clinical immunology. 2006 Oct;118(4):773-86; quiz 787-8