Aspirin-induced asthma phenotypes

Aspirin-induced asthma is classically severe and aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) that inhibit COX-1 may be dangerous. Thus, the distinction between aspirin-induced asthma and aspirin-tolerant asthma is a necessity. The association of nasal polyposis (and rhinitis), asthma and aspirin sensitivity described by Widal in 1922 is still valid. A prior asthmatic reaction associated with aspirin or NSAIDs is the best predictor of aspirin-induced asthma. However, among asthmatic patients and in particular those suffering from severe disease, the diagnosis is difficult to predict without aspirin provocation test. (C) 2011 Elsevier Masson SAS. All rights reserved.