Aspirin Intolerance in Patients with Chronic SinusitisGosepath J. · Hoffmann F. · Schäfer D. · Amedee R.G. · Mann W.J.
aDepartment of Otolaryngology, University of Mainz, School of Medicine, Mainz, Germany; bTulane University Medical Center, New Orleans, School of Medicine, New Orleans, La., USA
Aspirin intolerance in patients with chronic sinusitis is often a cause of early recurrence of symptoms after surgical treatment. This study assesses 84 patients who were tested for acetylsalicylic acid intolerance after presenting with symptoms like chronic rhinosinusitis, sometimes bronchial asthma, coexisting allergies or a history of aspirin sensitivity. Nasal polyposis was found in a majority of cases, often recurrent after previous surgery. The levels of eicosanoids such as peptido-leukotrienes and prostaglandin E2 were analyzed in isolated blood cells and compared with a healthy control group. Aspirin-intolerant patients showed elevated basal levels of peptido-leukotrienes and reduced basal levels of prostaglandin E2. Test results were graded in a system ranging from positive (68%), signifying aspirin intolerance, to borderline (18%) and negative results (14%). After screening patients with clinical findings indicating a possible aspirin intolerance, the results of this investigation reveal a strong correlation between the clinical symptomatology and the in vitro parameters of eicosanoid levels in isolated blood cells, indicating the need to induce aspirin tolerance to reduce the risk of recurrent rhinosinusitis.
Jan Gosepath, MD
Department of Otolaryngology, University of Mainz
Langenbeckstrasse 1, D–55101 Mainz (Germany)
Tel. +49 6131 177361, Fax +49 6131 176637
This paper was presented in part at the 115th annual spring meeting of the American Rhinologic Society in Palm Beach, Fla., USA, May 1998.
Received: Received: January 6, 1999
Accepted: January 14, 1999
Number of Print Pages : 5
Number of Figures : 2, Number of Tables : 1, Number of References : 22
ORL (Journal for Oto-Rhino-Laryngology and Its Related Specialties)
Founded 1938 as ‘Practica Oto-Rhino-Laryngologica’ by J. Berberich and E. Schlittler, continued by L. Rüedi 1947–1970, E. Huizinga 1948–1970, C.R. Pfaltz 1968–1984
Vol. 61, No. 3, Year 1999 (Cover Date: May-June 1999)
Journal Editor: W. Arnold, München
ISSN: 0301–1569 (print), 1423–0275 (Online)
For additional information: http://www.karger.com/journals/orl