Successful treatment of nasal polyps with low dose aspirin for asipirin sensitive patients

2020 ◽  
Vol 24 (8) ◽  
pp. 581-584
Author(s):  
Agnė Savonytė ◽  
Justas Arasimavičius ◽  
Darius Rauba ◽  
Violeta Kvedarienė
Keyword(s):  
Bronchial Asthma ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Severe Form ◽  
Alternative Methods ◽  
Aspirin Exacerbated Respiratory Disease ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Aspirin Intolerance ◽  
Methods Of Treatment

Aspirin-exacerbated respiratory disease (AERD) represents a severe form of chronic rhinosinusitis (CRS) characterized by nasal polyposis, bronchial asthma and aspirin intolerance. The following syndrome is difficult to manage. In this report, we present a case of hypersensitivity to acetylsalicylic acid (AsA) together with bronchial asthma and nasal polyps. This case proves that desensitization for aspirin is one of the alternative methods of treatment for nasal polyps and aspirin-induced asthma for people hypersensitive to aspirin.

scholarly journals CD133, a Progenitor Cell Marker, is Reduced in Nasal Polyposis and Showed Significant Correlations with TGF-β1 and IL-8

2021 ◽  
Author(s):  
Wagner Vargas Souza Lino ◽  
André Luis Lacerda Bachi ◽  
José Arruda Mendes Neto ◽  
Gabriel Caetani ◽  
Jônatas Bussador do Amaral ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Transforming Growth Factor ◽  
Middle Turbinate ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Histologic Analysis ◽  
Aspirin Intolerance ◽  
Tgf Β1

Abstract Introduction Combination of chronic inflammation and an altered tissue remodeling process are involved in the development of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Studies demonstrated that mesenchymal stem cells expressing the progenitor gene CD133 were involved in a significant reduction of the chronic inflammatory process in the polypoid tissue. Objective To evaluate the levels of CD133 (Prominin-1) in nasal polypoid tissue and its correlation with interleukin-8 (IL-8) and transforming growth factor β1 (TGF-β1). Methods A total of 74 subjects were divided in the following groups: control group (n = 35); chronic rhinosinusitis with nasal polyps nonpresenting comorbid asthma and aspirin intolerance (CRSwNPnonAI) group (n = 27); and chronic rhinosinusitis with nasal polyps presenting comorbid asthma and aspirin intolerance (CRSwNPAI) group (n = 12). Histologic analysis and also evaluation of the concentration of CD133, IL-8, and TGF-β1 by enzyme-linked immunosorbent assay (ELISA) kits were performed in nasal tissue obtained from nasal polypectomy or from middle turbinate tissue. Results Higher eosinophilic infiltration was found in both CRSwNP groups by histologic analysis. Lower levels of TGF-β1 and IL-8 were observed in both CRSwNP groups when compared with the control group, whereas the CD133 levels were significantly reduced only in the CRSwNPnonAI group compared with the control group. Conclusion It was demonstrated that the nasal mucosa presenting polyposis showed a significant reduction of CD133 levels, and also that this reduction was significantly correlated with the reduction of TGF-β1 levels, but not with IL-8 levels. Therefore, these findings may be involved in the altered inflammatory and remodeling processes observed in the nasal polyposis.

scholarly journals Anaphylaxis in a Patient Undergoing FESS for Nasal Polyposis: Revisting Samter’s Triad

2021 ◽  
Author(s):  
Santvana Kohli ◽  
Mudit Varshney ◽  
Sahil Diwan
Keyword(s):  
Intensive Care ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Complete Recovery ◽  
Young Female ◽  
Sinus Surgery ◽  
Aspirin Exacerbated Respiratory Disease ◽  
Intensive Care Stay ◽  
Analgesic Agents ◽  
Samter’S Triad

Patients with nasal polyposis frequently have associated bronchial asthma and hypersensitivity to NSAIDs. When the three conditions co-exist, it is referred to as the Samter’s triad. Patients with Samter’s triad are an important subset of those with aspirin-exacerbated respiratory disease (AERD). We present a case of a young female patient undergoing endoscopic sinus surgery for nasal polyps, who although did not show any other features of AERD, went on to develop florid anaphylaxis to diclofenac administration intra-operatively. After adequate resuscitation and intensive care stay, the patient made a complete recovery. NSAIDs must be avoided in patients with nasal polyps, despite showing no other features of this syndrome. Other analgesic agents that can be used include IV paracetamol and opioids like tramadol.

Low-dose aspirin desensitization in individuals with aspirin-exacerbated respiratory disease

Allergy ◽  
2013 ◽  
Vol 68 (5) ◽  
pp. 659-665 ◽  
Author(s):  
K. Fruth ◽  
B. Pogorzelski ◽  
I. Schmidtmann ◽  
J. Springer ◽  
N. Fennan ◽  
...  
Keyword(s):  
Respiratory Disease ◽  
Low Dose ◽  
Aspirin Desensitization ◽  
Aspirin Exacerbated Respiratory Disease ◽  
Dose Aspirin ◽  
Low Dose Aspirin

Analysis of the impact of bronchial asthma and hypersensitivity to aspirin on the clinical course of chronic sinusitis with nasal polyps

2019 ◽  
Vol 73 (5) ◽  
pp. 1-5
Author(s):  
Marta Podwysocka ◽  
Katarzyna Dąbrowska-Monti ◽  
Wojciech Fendler ◽  
Konrad Pagacz ◽  
Wioletta Pietruszewska
Keyword(s):  
Bronchial Asthma ◽  
Nasal Polyps ◽  
Endoscopic Examination ◽  
Interleukin 4 ◽  
Number Of Patients ◽  
Asthma Patients ◽  
Aspirin Triad ◽  
Aspirin Intolerance ◽  
Severity Of The Disease ◽  
The Impact

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a disease with still not enough known pathogenesis despite the development of genetics, immunological and microbiological research. The number of patients with CRS has been constantly growing. The coexistence of CRS, bronchial asthma and aspirin intolerance (aspirin triad) is an adverse prognostic factor with higher risk of recurrences. The aim of study was to compare the severity of CRSwNP depending of coexistence of bronchial asthma and/or aspirin intolerance. The research was performed in the group of 204 patients operated 2009-2013 with 5 years follow-up. Higher nasal polyps growth in groups of patients with aspirin triad and CRSwNP and bronchial asthma in endoscopic examination (p=0,0005 and p=0,0030 respectively) and CT-scan according to Lund-Mackay point scale (p<0,0001 and p=0,0009) was showed. Also, these patients presented increased severity of nasal symptoms before surgical treatment according to VAS scale (p=0,0126 for CRSwNP with bronchial asthma; p=0,0390 for aspirin triad). Similarly, 6 months after surgery the same groups of patients presented higher severity of the disease symptoms (p<0,0001 for aspirin triad’ patients; p=0,0174 for CRSwNP and bronchial asthma’ patients) . Patients with aspirin triad had also statistically more surgeries in past (p=0,001), what proves that recurrences in this group are very likely to be observed in spite of the use of proper conservative treatment. No such differences have been shown in the group of patients with CRSwNP and isolated aspirin intolerance (without bronchial asthma). Allergy to inhaled allergens, hypersensitivity to aspirin are factors significantly worsening the course of CRSwNP. It would be advisable to consider, despite a lack of history of aspirin intolerance, a hypersensititvity to aspirin test in patients with particularly severe CRSwNP, especially those associated with bronchial asthma. It also seems reasonable to carry out such a test on every patient with newly diagnosed CRSwNP and bronchial asthma in order to be able to plan further treatment in this group of patients accordingly including biological treatment with antimonoclonal therapy against interleukin 4, 5 or13.

Alert Issued on Low-Dose Aspirin + Ibuprofen

2006 ◽  
Vol 34 (10) ◽  
pp. 8
Author(s):  
ELIZABETH MECHCATIE
Keyword(s):  
Low Dose ◽  
Dose Aspirin ◽  
Low Dose Aspirin

Investigation of the Interaction of Blood Platelets with the Coagulation System at the Site of Plug Formation In Vivo in Man - Effect of Low-Dose Aspirin

1987 ◽  
Vol 57 (01) ◽  
pp. 062-066 ◽  
Author(s):  
P A Kyrle ◽  
J Westwick ◽  
M F Scully ◽  
V V Kakkar ◽  
G P Lewis
Keyword(s):  
Platelet Activation ◽  
Thrombin Generation ◽  
Low Dose ◽  
Bleeding Time ◽  
Blood Platelets ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Plug Formation ◽  
Granule Release

SummaryIn 7 healthy volunteers, formation of thrombin (represented by fibrinopeptide A (FPA) generation, α-granule release (represented by β-thromboglobulin [βTG] release) and the generation of thromboxane B2 (TxB2) were measured in vivo in blood emerging from a template bleeding time incision. At the site of plug formation, considerable platelet activation and thrombin generation were seen within the first minute, as indicated by a 110-fold, 50-fold and 30-fold increase of FPA, TxB2 and PTG over the corresponding plasma values. After a further increase of the markers in the subsequent 3 minutes, they reached a plateau during the fourth and fifth minute. A low-dose aspirin regimen (0.42 mg.kg-1.day-1 for 7 days) caused >90% inhibition of TxB2formation in both bleeding time blood and clotted blood. At the site of plug formation, a-granule release was substantially reduced within the first three minutes and thrombin generation was similarly inhibited. We conclude that (a) marked platelet activation and considerable thrombin generation occur in the early stages.of haemostasis, (b) α-granule release in vivo is partially dependent upon cyclo-oxygenase-controlled mechanisms and (c) thrombin generation at the site of plug formation is promoted by the activation of platelets.

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