ABSTRACT
A subset of asthmatic patients experience adverse respiratory reactions to aspirin (ASA) and nonsteroidal anti-inflammatory drugs (NSAIDs), including nasal and ocular mucosal swelling and bronchospasm. Such asthmatic patients have been classified as ASA sensitive (1), ASA intolerant (2), ASA idiosyncratic (3), or ASA-induced asthma (AIA) (4). All four descriptors refer to the same population of asthmatics. This chapter focuses on the clinical features of ASA respiratory disease; methods for diagnosis of ASA sensitivity; prevalence of ASA sensitive asthma; cross-reactions with NSAIDs; lack of cross-reactions with cyclooxygenase-2-(COX-2) inhibiting NSAIDs, as well as with other drugs and chemicals; the phenomenon of ASA desensitization; and treatment. Comments regarding the severity of asthma in ASA-sensitive asthmatics are focused in two areas: (1) respiratory reactions, which are sometimes life threatening and occur after ingesting ASA and NSAIDs; and (2) aspirin respiratory disease, particularly the relationship between active sinusitis and stimulation of asthma.
