Aspirin-Induced Asthma and Aspirin-Induced Polyps

Abstract

Asthma, aspirin intolerance and nasal polyps form the triad of aspirin-induced asthma (AIA). The prevalence of AIA is thought to be approximately 10% in asthmatic pati ents in general. This side effect is known also to be caused by non-steroidal anti-inflammatory drugs (NSAID) and dyes such as tartrazine, parabens, etc. The diagnosis usually can be established easily on the basis of the history. AIA is not a rare disease in Japan. Fourtyfour cases of AIA,14 male and 30 female, were seen at our clinic as of 1990. Asthma was found in 41 of 44 cases (93.2%) and sinusitis in 28 of 43 (65.1%). The incidence of nasal polyps, so-called aspirin-induced polyps (AIP), was very high, ranging from 60% to 95%. In our clinic, AIP were found in 29 of 43 cases (67.4%). AIP are characteristically bilateral and recur easily. Histological findings show significant infiltration of eosinophils with marked eosinophilia in the blood and nasal secretions. Nasal polypectomy is useful for AIA, because asthma is aggravated by mouth breathing caused by severe nasal obstruction. The pathogenesis of AIA and AIP is obscure but is probably related to inhibition of prostaglandin biosynthesis, though other factors may also be related, including viral infection.