Aspirin-Exacerbated Respiratory Disease

Evan S Walgama; Peter H Hwang

doi:10.1016/j.otc.2016.08.007

Aspirin-Exacerbated Respiratory Disease

Otolaryngol Clin North Am. 2017 Feb;50(1):83-94. doi: 10.1016/j.otc.2016.08.007.

Authors

Evan S Walgama¹, Peter H Hwang²

Affiliations

¹ Department of Otolaryngology/Head and Neck Surgery, Stanford School of Medicine, Stanford Sinus Center, 801 Welch Road, Palo Alto, CA 94304, USA.
² Department of Otolaryngology/Head and Neck Surgery, Stanford School of Medicine, Stanford Sinus Center, 801 Welch Road, Palo Alto, CA 94304, USA. Electronic address: hwangph@stanford.edu.

PMID: 27888917
DOI: 10.1016/j.otc.2016.08.007

Abstract

Aspirin-exacerbated respiratory disease (AERD) is characterized by the triad of asthma, sinonasal polyposis, and aspirin intolerance. The hallmark of the disease is baseline overproduction of cysteinyl leukotrienes via the 5-lipoxygenase pathway, exacerbated by ingestion of aspirin. Patients with AERD have high rates of recidivistic polyposis following sinus surgery, although the improvement in quality of life following surgery is similar to aspirin-tolerant patients. The diagnosis is secured by a positive aspirin provocation test, usually administered by a medical allergist. Aspirin therapy is a unique treatment consideration for patients with AERD.

Keywords: Aspirin-exacerbated respiratory disease; Chronic rhinosinusitis; Nasal polyposis; Sinus surgery.

Publication types

Review

MeSH terms

Anti-Inflammatory Agents, Non-Steroidal / adverse effects
Anti-Inflammatory Agents, Non-Steroidal / pharmacology
Arachidonate 5-Lipoxygenase / metabolism
Aspirin* / adverse effects
Aspirin* / pharmacology
Asthma, Aspirin-Induced* / diagnosis
Asthma, Aspirin-Induced* / metabolism
Asthma, Aspirin-Induced* / therapy
Disease Management
Humans
Leukotrienes / metabolism
Nasal Polyps* / etiology
Nasal Polyps* / metabolism
Nasal Polyps* / therapy

Substances

Anti-Inflammatory Agents, Non-Steroidal
Leukotrienes
Arachidonate 5-Lipoxygenase
Aspirin