Aspirin Exacerbated Respiratory Disease

This patient's history of wheezing following the ingestion of naproxen as well as her symptoms ofrhinitis and post-nasal drainage are highly suggestive of aspirin exacerbated respiratory disease(AERD), a condition commonly associated with the development of nasal polyps.

AERD consists of the following features:

1. asthma,
2. chronic rhinosinusitis with nasal polyposis, and
3. bronchospasm or nasal congestion following the ingestion of aspirin or non-steroidal anti-inflammatory drugs (NSAIDS).

The diagnosis of AERD can often be made clinically when all three of these conditions are present.

mis patients current symptoms of bland tasting food (secondary to anosmia) and recurrent nasal discharge/congestion are typical in patients with nasal polyps, and examination should reveal the presence of bilateral, grey, glistening mucoid masses in her nasal cavities.

Diagnostic aspirin challenge (for research purpose) — Aspirin challenge is the only way to definitively diagnose type 1 pseudoallergy to NSAIDs, and thus AERD.

Tx

Although surgery can often provide temporary relief, the polyps tend to recur andultimate treatment should be geared toward medical management of the underlying etiology

Leukotriene-modifying agents

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