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The nose as a target organ in the diagnosis of severe aspirin-exacerbated respiratory disease

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Abstract:

Background:

The nasal provocation test (NPT) with lysine aspirin is a useful tool in the diagnosis of aspirin-exacerbated respiratory disease (AERD), previously reffered to as Samter′s disease. The aim of the present study focuses on methodological interventions to show the usefulness of the NPT with lysine aspirin in differentiating AERD patients from aspirin-tolerant asthma (ATA) patients to improve the diagnostic efficacy and minimize the risk for adverse reactions compared with the gold standard.

Methods:

Thirty AERD patients comprised the active study group while the control group consisted of 25 ATA patients. A combination of objective nasal aerodynamic response (i.e., nasal inspiratory flow and nasal inspiratory resistance) was evaluated by active anterior rhinomanometry and the subjective clinical nasal and extranasal symptoms (including forced expiratory volume) were monitored throughout the challenge.

Results:

Fifty-five NPTs were successfully completed: sensitivity, 87%; specificity, 100%; positive predictive value, 100%; negative predictive value, 86%; global efficacy, 92.72%. No severe adverse reactions were recorded.

Conclusion:

The present NPT with lysine aspirin proved to be a safe, efficient, and a timesaving method in the diagnosis of patients with AERD, even in those with severe rhinitis‐rhinosinusitis and/or recurrent nasal polyposis.

Keywords: Aspirin-exacerbated respiratory disease; NSAID intolerance; Samter′s disease; diagnosis; lysine aspirin; nasal aerodynamics; nasal provocation test; rhinitis; rhinomanometry; rhinosinusitis

Document Type: Research Article

DOI: http://dx.doi.org/10.2500/ajra.2011.25.3591

Affiliations: Servicio de Alergia, Hospital Universitario N.Sra. La Candelaria, Santa Cruz de Tenerife, Spain

Publication date: May 1, 2011

More about this publication?
  • The American Journal of Rhinology & Allergy, is a peer reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    Previously published as American Journal of Rhinology, the journal is indexed in Thomson Reuters Web of Science and Science Citation Index, plus the National Library of Medicine's PubMed service.
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