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nasal polyps with asthma; aspirin-exacerbated respiratory disease; Samter syndrome

Pathology: - mucosal swelling of the paranasal sinuses & nasal membranes - formation of nasal polyps - asthma precipitated by exposure to cyclooxygenase-1 [4] Clinical manifestations: - nasal polyps - asthma & rhinosinusitus precipitated by exposure to aspirin or other NSAID [4] - aspirin sensitivity Management: - avoid aspirin, NSAIDs - stepped asthma care, including leukotriene receptor antagonist [4] Notes: - COX2 inhibitors may be better tolerated than non-selective NSAIDs - patients usually will tolerate celecoxib better than meloxicam

Related

asthma

General

nasal polyp syndrome

References

  1. Morales DR et al. Safety risks for patients with aspirin-exacerbated respiratory disease after acute exposure to selective nonsteroidal anti-inflammatory drugs and COX-2 inhibitors: Meta-analysis of controlled clinical trials. J Allergy Clin Immunol 2014 Jul; 134:40 PMID: 24388008
  2. White AA, Stevenson DD Aspirin-Exacerbated Respiratory Disease. N Engl J Med 2018; 379:1060-1070 PMID: 30207919 https://www.nejm.org/doi/full/10.1056/NEJMra1712125
  3. Ledford DK, Wenzel SE, Lockey RF. Aspirin or other nonsteroidal inflammatory agent exacerbated asthma. J Allergy Clin Immunol Pract. 2014 Nov-Dec;2(6):653-7. Review. PMID: 25439353
  4. Medical Knowledge Self Assessment Program (MKSAP) 19 American College of Physicians, Philadelphia 2022 - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022