Clinical Characteristics of Patients with Chronic Rhinosinusitis with Nasal Polyps, Asthma, and Aspirin-Exacerbated Respiratory Disease

被引:197
作者
Stevens, Whitney W. [1 ]
Peters, Anju T. [1 ]
Hirsch, Annemarie G. [2 ]
Nordberg, Cara M. [2 ]
Schwartz, Brian S. [3 ,4 ,5 ]
Mercer, Dione G. [2 ]
Mahdavinia, Mahboobeh [1 ]
Grammer, Leslie C. [1 ]
Hulse, Kathryn E. [1 ]
Kern, Robert C. [6 ]
Avila, Pedro [1 ]
Schleimer, Robert P. [1 ,6 ]
机构
[1] Northwestern Univ, Dept Med, Feinberg Sch Med, Div Allergy Immunol, Chicago, IL 60611 USA
[2] Geisinger Hlth Syst, Ctr Hlth Res, Danville, PA USA
[3] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Environm Hlth Sci, Baltimore, MD USA
[4] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
[5] Johns Hopkins Sch Med, Dept Med, Baltimore, MD USA
[6] Northwestern Univ, Dept Otolaryngol, Feinberg Sch Med Chicago, Chicago, IL 60611 USA
基金
美国国家卫生研究院;
关键词
AERD; CRS; CRSwNP; Asthma; Samter's disease; Sinus; ENDOSCOPIC SINUS SURGERY; PROSTAGLANDIN E-2; RESEARCH-PROGRAM; NATURAL-HISTORY; OUTCOMES; PREVALENCE; SEVERITY; DIAGNOSIS; PATHOGENESIS; METAANALYSIS;
D O I
10.1016/j.jaip.2016.12.027
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
BACKGROUND: Aspirin-exacerbated respiratory disease (AERD) comprises the triad of chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and intolerance to inhibitors of the cyclooxygenase-1 (COX-1) enzyme. The prevalence of AERD remains unclear, and few studies have compared the clinical characteristics of patients with AERD to those with CRSwNP alone, asthma alone, or both CRSwNP and asthma. OBJECTIVE: To determine the prevalence of AERD within a tertiary care setting, and to identify unique clinical features that could distinguish these patients from those with both CRSwNP and asthma or with CRSwNP alone. METHODS: Electronic medical records of patients at Northwestern in Chicago, Illinois, were searched by computer algorithm and then manual chart review to identify 459 patients with CRSwNP alone, 412 with both CRSwNP and asthma, 171 with AERD, and 300 with asthma only. Demographic and clinical features including sex, atopy, and sinus disease severity were characterized. RESULTS: The prevalence of AERD among patients with CRSwNP was 16%. Patients with AERD had undergone 2-fold more sinus surgeries (P < .001) and were significantly younger at the time of their first surgery (40 +/- 13 years) than were patients with CRSwNP (43 +/- 14 years; P < .05). Atopy was significantly more prevalent in patients with AERD (84%) or asthma (85%) than in patients with CRSwNP (66%, P < .05). More patients with AERD (13%) had corticosteroid-dependent disease than patients with both CRSwNP and asthma (4%, P < .01) or asthma (1%, P < .001). CONCLUSIONS: AERD is common among patients with CRSwNP; even though patients with AERD have CRSwNP and asthma, the clinical course of their disease is not the same as of patients who have CRSwNP and asthma but are tolerant to COX-1 inhibitors. (C) 2017 American Academy of Allergy, Asthma & Immunology
引用
收藏
页码:1061 / +
页数:13
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