Aspirin-induced asthma

Aspirin-induced asthma is also termed Samter's triad, Samter's syndrome, aspirin-exacerbated respiratory disease (AERD), and recently by an appointed task force of the European Academy of Allergy and Clinical Immunology/World Allergy Organization (EAACI/WAO) Non-steroidal anti-inflammatory drugs-exacerbated respiratory disease (NERD). The syndrome, which EAACI/WHO classifies as one of 5 types of non-steroidal anti-inflammatory drug hypersensitivity or NSAID hypersensitivity reactions, is a medical condition initially defined as consisting of three key features viz., asthma, symptom evocation by aspirin, and nasal/ethmoidal polyposis; however, the syndrome's symptoms are evoked by a large variety of other NSAID besides aspirin and rhinitis is an important accompaniment to, and often the earliest manifestation of, AERD. The asthma and rhinitis components of this syndrome are hypersensitivity reactions to NSAID rather than true allergic reactions that trigger common allergen-induced asthmatic and rhinitis responses; the syndrome does not appear to involve, for example, the common mediators of allergen-induced disease, immunoglobulin E or T cells. Rather, aspirin-induced asthma is a subtype of NSAID-induced non-allergic syndromes that include NSAID-induced urticaria/angioedema associated with underlying chronic urticaria, NSAID-induced urticaria/angioedema not associated chronic urticarial, and various other types of typically delayed (i.e. more than 1 day post-exposure) pathological responses to NSAID such as bullous or maculopapular skin eruptions, contact dermatitis, photocontact dermatitis, pneumonitis, and aseptic meningitis. It should be noted, however, that about 10% of patients with AERD manifest urticaria and/or angioedema reactions to NSAID.