Nasal provocation test with lysine-aspirin for diagnosis of aspirin-sensitive asthma

摘要: Nasal provocation tests (NPTs) with lysine-aspirin (L-ASA) have been recently introduced for assessment of aspirin-induced asthma (AIA). They differ in dose and means aspirin instillation, duration observation period, criteria positivity. Thus far they not become a routine part clinical diagnosis. Fifty-one patients AIA, confirmed by oral challenge test, were recruited to undergo diagnostic NPTs L-ASA. In 10 these (19.6%), could be performed because total obstruction at least one nostril or marked fluctuations nasal flows, leaving 41 AIA the study. Control groups consisted 13 aspirin-tolerant asthmatic healthy subjects. L-ASA 16 mg acetylsalicylic acid applied bilaterally into inferior conchae caused significant fall inspiratory flow (>40%), which was measured anterior rhinomanometry, symptoms watery discharge blockage 35 subjects, none patients. No relationship found between baseline values intensity response systemic reactions, including bronchospasm, noticed, even whose initial FEV1 lower than 70% predicted value. This test is highly specific (95.7%) sensitive (86.7%), but negative results do exclude possible intolerance (predictive value result 78.6%). conclusion, NPT described simple, safe, quick diagnosis AIA. It can used unstable asthma. may method choice confirm hypersensitivity manifested only from upper respiratory tract. Patients suspected who should bronchial aspirin.