Alcohol-induced Respiratory Symptoms Are Common in Patients With Aspirin Exacerbated Respiratory Disease

被引:68
作者
Cardet, Juan Carlos [1 ]
White, Andrew A. [2 ]
Barrett, Nora A. [1 ,3 ]
Feldweg, Anna M. [1 ,3 ]
Wickner, Paige G. [1 ,3 ]
Savage, Jessica [1 ,3 ]
Bhattacharyya, Neil [4 ,5 ]
Laidlaw, Tanya M. [1 ,3 ]
机构
[1] Brigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA
[2] Scripps Clin, Div Allergy Asthma & Immunol, San Diego, CA USA
[3] Harvard Univ, Sch Med, Dept Med, Boston, MA USA
[4] Harvard Univ, Sch Med, Dept Surg, Boston, MA 02115 USA
[5] Brigham & Womens Hosp, Div Otolaryngol, Boston, MA 02115 USA
基金
美国国家卫生研究院;
关键词
Samter Triad; Aspirin exacerbated respiratory disease; AERD; Aspirin intolerant asthma; Aspirin triad; Nonsteroidal anti-inflammatory drug; Asthma; Alcohol; Wine; Leukotriene; WINE-INDUCED ASTHMA; NATURAL-HISTORY; DRINKS; PREVALENCE; CHALLENGES; HYPERRESPONSIVENESS; HYPERSENSITIVITY; LEUKOTRIENE-E4; PATHOGENESIS; GUIDELINE;
D O I
10.1016/j.jaip.2013.12.003
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
BACKGROUND: A large percentage of patients with aspirin exacerbated respiratory disease (AERD) report the development of alcohol-induced respiratory reactions, but the true prevalence of respiratory reactions caused by alcoholic beverages in these patients was not known. OBJECTIVE: We sought to evaluate the incidence and characteristics of alcohol-induced respiratory reactions in patients with AERD. METHODS: A questionnaire designed to assess alcohol-induced respiratory symptoms was administered to patients at Brigham and Women's Hospital and Scripps Clinic. At least 50 patients were recruited into each of 4 clinical groups: (1) patients with aspirin challengee confirmed AERD, (2) patients with aspirin-tolerant asthma (ATA), (3) patients with aspirin tolerance and with chronic rhinosinusitis, and (4) healthy controls. Two-tailed Fisher exact tests with Bonferroni corrections were used to compare the prevalence of respiratory symptoms among AERD and other groups, with P <= .017 considered significant. RESULTS: The prevalence of alcohol-induced upper (rhinorrhea and/or nasal congestion) respiratory reactions in patients with AERD was 75% compared with 33% with aspirin-tolerant asthma, 30% with chronic rhinosinusitis, and 14% with healthy controls (P < .001 for all comparisons). The prevalence of alcohol-induced lower (wheezing and/or dyspnea) respiratory reactions in AERD was 51% compared with 20% in aspirin-tolerant asthma and with 0% in both chronic rhinosinusitis and healthy controls (P < .001 for all comparisons). These reactions were generally not specific to one type of alcohol and often occurred after ingestion of only a few sips of alcohol. CONCLUSION: Alcohol ingestion causes respiratory reactions in the majority of patients with AERD, and clinicians should be aware that these alcohol-induced reactions are significantly more common in AERD than in controls who are aspirin tolerant. (C) 2014 American Academy of Allergy, Asthma & Immunology
引用
收藏
页码:208 / U240
页数:8
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