UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Nasal lysine aspirin challenge in the diagnosis of aspirin - exacerbated respiratory disease

Miller, B; Mirakian, R; Gane, S; Larco, J; Sannah, AA; Darby, Y; Scadding, G; (2013) Nasal lysine aspirin challenge in the diagnosis of aspirin - exacerbated respiratory disease. Clinical & Experimental Allergy , 43 (8) 874 - 880. 10.1111/cea.12110. Green open access

[thumbnail of cea12110.pdf]
Preview
PDF
cea12110.pdf
Available under License : See the attached licence file.

Download (260kB)

Abstract

Background Aspirin-exacerbated respiratory disease is under-diagnosed and therefore effective and inexpensive therapy with aspirin desensitization is rarely performed. Methods We present an audit of 150 patients with difficult to treat nasal polyposis, 132 of whom also had asthma, 131 of whom underwent challenge with the only soluble form of aspirin, lysine aspirin (LAS), to confirm or exclude the diagnosis of aspirin-exacerbated respiratory disease (AERD). Results One hundred patients proved positive on nasal challenge, 31 who were negative went onto oral LAS challenge and a further 14 gave positive results, leaving 17 who were negative to a dose equivalent to over 375 mg of aspirin. Nineteen were not challenged because of contraindications. With the exception of one patient who developed facial angioedema and two patients with > 20% drop in FEV1 (following nasal plus oral challenge) no other severe adverse events occurred. No hospitalization was required for these three patients. Nasal inspiratory peak flow monitoring was less sensitive to obstruction caused by aspirin than was acoustic rhinometry – which should be employed when aspirin challenge is an outpatient procedure. Conclusions Provided patients are carefully chosen and monitored LAS challenge is suitable for ENT day case practice where respiratory physician help with asthma is available and should reduce the under-diagnosis of this condition.

Type: Article
Title: Nasal lysine aspirin challenge in the diagnosis of aspirin - exacerbated respiratory disease
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/cea.12110
Publisher version: http://dx.doi.org/10.1111/cea.12110
Language: English
Additional information: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
URI: https://discovery.ucl.ac.uk/id/eprint/1469782
Downloads since deposit
114Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item