| Oral and bronchial provocation tests with aspirin for diagnosis of aspirin-induced asthma. | |
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MedLine Citation:
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PMID: 10853850 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In 35 asthmatic patients with acetylsalicylic acid (aspirin; ASA) intolerance (AIA) and 15 asthmatics tolerating ASA well, the authors compared the diagnostic value of the placebo-controlled oral ASA versus inhaled L-lysine (L) ASA challenges. All AIA subjects gave a history of asthmatic attacks following ingestion of ASA and in all of them the intolerance was confirmed by oral challenge test over the past 10 yrs. Doses of ASA increasing in geometric progression were used in oral tests 10-312 mg (cumulative dose 500 mg); in bronchial tests 0.18-115 mg (cumulative dose 182 mg). Either challenge was considered as positive, if forced expiratory volume in one second (FEV1) dropped at least 20% from the baseline value and/or strong extrabronchial symptoms of intolerance occurred. Urinary leukotriene E4 excretion was determined at baseline and following the challenges. In 24 out of 35 patients the oral test was positive, based on a 20% decrease in FEV1. When including extrabronchial symptoms this was positive in 31 cases. Bronchial L-ASA challenge led to > or =20% fall FEV1 in 21 out of 35 cases, and in 27 cases when including extrabronchial symptoms. No correlation was observed between ASA provocative dose causing a 20% fall in FEV1, determined by the oral route compared to the inhalation route. Urinary LTE4 increased after both challenges the rise being higher following oral as compared to inhalation provocation (p=0.0001). It is concluded that both tests had similar specificity whilst the oral test showed a tendency to higher sensitivity for the clinical diagnosis of acetylsalicylic acid intolerance. The inclusion of extrabronchial symptoms into the criteria of test positivity enhanced the diagnostic value of both procedures. In both tests the highest leukotriene E4 increases were found in the presence of extrabronchial symptoms, suggesting the participation of tissues other than the lung in aspirin induced leukotriene E4 release to urine. |
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Authors:
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E Nizankowska; A Bestyńska-Krypel; A Cmiel; A Szczeklik |
Publication Detail:
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Type: Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article |
Journal Detail:
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Title: The European respiratory journal Volume: 15 ISSN: 0903-1936 ISO Abbreviation: Eur. Respir. J. Publication Date: 2000 May |
Date Detail:
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Created Date: 2000-10-18 Completed Date: 2000-10-18 Revised Date: 2013-05-23 |
Medline Journal Info:
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Nlm Unique ID: 8803460 Medline TA: Eur Respir J Country: DENMARK |
Other Details:
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Languages: eng Pagination: 863-9 Citation Subset: IM |
Affiliation:
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Jagiellonian University School of Medicine, Dept of Medicine, Cracow, Poland. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anti-Inflammatory Agents, Non-Steroidal / adverse effects*, diagnostic use* Aspirin / adverse effects, analogs & derivatives*, diagnostic use Asthma / chemically induced*, diagnosis*, urine Bronchial Provocation Tests* Female Humans Leukotriene E4 / urine Lysine / adverse effects, analogs & derivatives*, diagnostic use Male Middle Aged Mouth |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents, Non-Steroidal; 37933-78-1/acetylsalicylic acid lysinate; 50-78-2/Aspirin; 56-87-1/Lysine; 75715-89-8/Leukotriene E4 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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