Women are twice more likely to be affected by aspirin-induced asthma. Symptoms usually develop gradually over several years [1], but patients with rapid progression have also been described [2]. If patients are atopic, chronic rhinitis and asthma occur earlier in life, unlike aspirin intolerance and nasal polyps [3]. The sense of smell is diminished in these patients [4]. Chronic asthma may have any severity. Even mild, intermittent asthma patients may have acute episodes induced by aspirin consumption and up to one-quarter of patients that need to be admitted to the hospital due to a crisis have ingested non-steroidal anti-inflammatories during the last 3 hours [5]. Respiratory symptoms (wheezing, dyspnea, cough) and chest pain [6] that that radiates to the jaw or arms and is accompanied by diaphoresis and nausea develop together with nasal obstruction or rhinorrhea, periorbital edema, facial flushing or macular rash [7] and conjunctival injection. Less frequently, patients also have abdominal pain, hypotension, and laryngospasm.

If nasal polyps are removed, they tend to recur. Sinus mucosa is also polypoidal and hypertrophied. The initial episode of rhinitis in these patients often occurs after a viral infection [8].

The diagnosis of aspirin induced asthma is made from the history and clinical examination. In uncertain cases, challenge tests may be useful [8] for confirmation of the diagnosis. But, as they can provoke severe asthmatic episodes, they should only be performed in the hospital and aspirin can be administered by various routes: oral, nasal, bronchial and intravenous, in increasing doses for four consecutive days. Following administration, if a fall in forced expiratory volume in one second of at least 20% is observed, the test is considered positive [9]. Patients should receive leukotriene-modifying agents before the test because they have been proven to diminish the severity of bronchial constriction, while nasal and ocular symptoms tend to still appear, so the clinician can interpret the results of the test as positive. If lysine- aspirin is administered by inhalation route, only bronchial symptoms will occur. Inhalation tests may remain negative even in patients with positive oral tests. Oral and bronchial tests have similar specificity, but the oral test is more sensitive.

Several tests have been used over the years: histamine, methacholine, allergens and lysine-aspirin [10]. The Aspirin Sensitive Patient Identification Test is a new method to prove aspirin intolerance that still needs further validation [11].

Additional diagnostic methods include computer tomography scans of paranasal sinuses, that show mucosal hypertrophy and polyps. If the sinuses appear normal, the likelihood of aspirin-induced asthma is low.

Most patients are atopic [12] and some have increased respiratory antigen immunoglobulin E levels [13]. The peripheral eosinophil count can be high [14] and eosinophils are frequently found in the nasal and bronchial mucosa. The skin prick tests may be also positive for aeroallergens [15].

The primary treatment for Aspirin-Induced Asthma is the avoidance of aspirin and NSAIDs. Patients are advised to use alternative pain relievers, such as acetaminophen, which do not trigger asthma symptoms. In some cases, desensitization therapy may be considered, where patients are gradually exposed to increasing doses of aspirin under medical supervision. Asthma symptoms are managed with standard asthma treatments, including inhaled corticosteroids and bronchodilators.

With proper management and avoidance of aspirin and NSAIDs, individuals with Aspirin-Induced Asthma can lead normal, healthy lives. However, if the condition is not managed appropriately, it can lead to frequent asthma attacks and complications. Regular follow-ups with a healthcare provider are essential to monitor the condition and adjust treatment as needed.

The exact cause of Aspirin-Induced Asthma is not fully understood. It is believed to involve an abnormal response to aspirin and NSAIDs, leading to an overproduction of leukotrienes, which are inflammatory chemicals in the body. This overproduction causes the airways to constrict, leading to asthma symptoms. Genetic factors may also play a role, as AIA tends to run in families.

Aspirin-Induced Asthma affects approximately 7-10% of adults with asthma and is more common in individuals with severe asthma. It typically develops in adulthood, often between the ages of 20 and 50. The condition is more prevalent in women than in men. AIA is less common in children.

In Aspirin-Induced Asthma, the ingestion of aspirin or NSAIDs leads to an imbalance in the production of certain chemicals in the body. Specifically, there is a decrease in prostaglandins, which have protective effects on the airways, and an increase in leukotrienes, which cause inflammation and constriction of the airways. This imbalance results in the characteristic asthma symptoms.

The most effective way to prevent Aspirin-Induced Asthma is to avoid aspirin and NSAIDs. Patients should be educated about reading medication labels to identify these drugs. Wearing a medical alert bracelet can also be helpful in emergencies. For those who require aspirin for other medical conditions, desensitization therapy may be an option.

Aspirin-Induced Asthma is a condition where aspirin and NSAIDs trigger asthma symptoms. It is part of a syndrome that includes nasal polyps and chronic sinusitis. Diagnosis involves a detailed medical history and possibly an aspirin challenge. Treatment focuses on avoiding aspirin and managing asthma symptoms. With proper management, individuals can lead normal lives.

If you have asthma and experience worsening symptoms after taking aspirin or NSAIDs, you may have Aspirin-Induced Asthma. It's important to avoid these medications and consult with your healthcare provider for an accurate diagnosis and appropriate management. Alternative pain relievers are available, and your doctor can help you find the best options for your needs. Regular monitoring and adherence to your asthma treatment plan are key to maintaining good health.

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