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Hypersensitivity to Aspirin and other NSAIDs: Diagnostic Approach in Patients with Chronic Rhinosinusitis.

Makowska J, Lewandowska-Polak A, Kowalski ML - Curr Allergy Asthma Rep (2015)

Bottom Line: Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) associated with chronic rhinosinusitis (CRS) and/or asthma comprises a distinct clinical syndrome referred to as NSAIDs exacerbated respiratory disease (NERD).Patients with NERD tend to have more severe course of both upper (CRS and nasal polyps) and lower airway (asthma) diseases and are usually recalcitrant to conventional treatment modalities.Diagnosing and phenotyping of patients with NERD are critical for prevention of drug-induced adverse reactions and open novel options for management of underlying chronic airway inflammatory diseases.

View Article: PubMed Central - PubMed

Affiliation: Department of Immunology, Rheumatology and Allergy, Healthy Ageing Research Center, Medical University of Łódź, 251 Pomorska Str., 92-213, Łódź, Poland.

ABSTRACT
Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) associated with chronic rhinosinusitis (CRS) and/or asthma comprises a distinct clinical syndrome referred to as NSAIDs exacerbated respiratory disease (NERD). Patients with NERD tend to have more severe course of both upper (CRS and nasal polyps) and lower airway (asthma) diseases and are usually recalcitrant to conventional treatment modalities. Diagnosing and phenotyping of patients with NERD are critical for prevention of drug-induced adverse reactions and open novel options for management of underlying chronic airway inflammatory diseases. Diagnosis of NERD is based on detailed clinical history confirmed by challenge with aspirin, but new diagnostic approaches are currently being developed. This review article focuses on the diagnostic approach to a patient with CRS and hypersensitivity to NSAIDs, emphasizing the importance of diagnosis for proper patient's management.

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Advantages and limitations of oral, intranasal, and bronchial route of aspirin provocation in patients with NERD (modified from M.L. Kowalski In vivo diagnosis of NSAIDs hypersensitivity, in Global Atlas of Allergy, Eds C. A. Akdis I. Agache, pp. 158-160, EAACI, 2014)
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Fig3: Advantages and limitations of oral, intranasal, and bronchial route of aspirin provocation in patients with NERD (modified from M.L. Kowalski In vivo diagnosis of NSAIDs hypersensitivity, in Global Atlas of Allergy, Eds C. A. Akdis I. Agache, pp. 158-160, EAACI, 2014)

Mentions: Advantages and limitations of various provocation methods are summarized in Fig. 3.Fig. 3


Hypersensitivity to Aspirin and other NSAIDs: Diagnostic Approach in Patients with Chronic Rhinosinusitis.

Makowska J, Lewandowska-Polak A, Kowalski ML - Curr Allergy Asthma Rep (2015)

Advantages and limitations of oral, intranasal, and bronchial route of aspirin provocation in patients with NERD (modified from M.L. Kowalski In vivo diagnosis of NSAIDs hypersensitivity, in Global Atlas of Allergy, Eds C. A. Akdis I. Agache, pp. 158-160, EAACI, 2014)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4493793&req=5

Fig3: Advantages and limitations of oral, intranasal, and bronchial route of aspirin provocation in patients with NERD (modified from M.L. Kowalski In vivo diagnosis of NSAIDs hypersensitivity, in Global Atlas of Allergy, Eds C. A. Akdis I. Agache, pp. 158-160, EAACI, 2014)
Mentions: Advantages and limitations of various provocation methods are summarized in Fig. 3.Fig. 3

Bottom Line: Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) associated with chronic rhinosinusitis (CRS) and/or asthma comprises a distinct clinical syndrome referred to as NSAIDs exacerbated respiratory disease (NERD).Patients with NERD tend to have more severe course of both upper (CRS and nasal polyps) and lower airway (asthma) diseases and are usually recalcitrant to conventional treatment modalities.Diagnosing and phenotyping of patients with NERD are critical for prevention of drug-induced adverse reactions and open novel options for management of underlying chronic airway inflammatory diseases.

View Article: PubMed Central - PubMed

Affiliation: Department of Immunology, Rheumatology and Allergy, Healthy Ageing Research Center, Medical University of Łódź, 251 Pomorska Str., 92-213, Łódź, Poland.

ABSTRACT
Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) associated with chronic rhinosinusitis (CRS) and/or asthma comprises a distinct clinical syndrome referred to as NSAIDs exacerbated respiratory disease (NERD). Patients with NERD tend to have more severe course of both upper (CRS and nasal polyps) and lower airway (asthma) diseases and are usually recalcitrant to conventional treatment modalities. Diagnosing and phenotyping of patients with NERD are critical for prevention of drug-induced adverse reactions and open novel options for management of underlying chronic airway inflammatory diseases. Diagnosis of NERD is based on detailed clinical history confirmed by challenge with aspirin, but new diagnostic approaches are currently being developed. This review article focuses on the diagnostic approach to a patient with CRS and hypersensitivity to NSAIDs, emphasizing the importance of diagnosis for proper patient's management.

Show MeSH
Related in: MedlinePlus