Nesnášenlivost kyselinyacetylosalicylové zjištěná nasálnímprovokačním testem u nemocnýchs nosní polypózou

Acetylsalicylic Acid Intolerance Assessed by Nasal ChallengeTest in Patients with Nasal Polyposis

In 48 patients with nasal polyps (NP) without data on acetylsalicylic acid (ASA)intolerance recorded in the case-history the nasal challenge test with acetylsalicylic lysine wasmade. The group comprised 23 patients with nasal polyps and bronchial asthma and 25 patientswith nasal polyposis without asthma. The test could not be performed in six patients because of anincreased non-specific sensitivity. The group of 42 patients was analyzed and the test could beevaluated. The test was positive in 16 patients, negative in 26 patients. The challenge test confirmedASA intolerance in 11 of 19 (58 %) patients with NP associated with asthma and in 5 of 23 (22 %)patients with NP without asthma. The difference between the groups was statistically significant(p = 0.012). The major part of patients with nasal polyps and bronchial asthma thus representeda clinically not fully expressed syndrome of the triad asthma, polyps, ASA intolerance.A permanent or frequent suppurative nasal secretion was found in 14 of 16 patients with a positiveASA test, at the borderline of statistical significance (p = 0.089) more frequently when comparedwith the group of ASA negative patients. This symptom was thus typical for patients with anincompletely expressed syndrome of ASA intolerance.

Key words:
nasal polyps, asthma bronchiale, nasal challenge test, lysine aspirin, aspirin