Table of contents:
- A story: 10 years of searching without clarity, what disease is this?
- What is aspirin or AERD-generated respiratory disease?
- What drugs can trigger this disease besides aspirin?
- How
Aspirin is a drug that is well known since the days of our great-grandmothers, is often used to reduce pain, reduce fever, and is now widely used as a blood clot prevention agent in people with heart disease (as an anti-platelet). But who would have thought that this beneficial aspirin could cause respiratory side effects that even doctors often have difficulty diagnosing? Find out more about aspirin or aspirin-generated respiratory diseasesaspirin-exacerbated respiratory disease (AERD).
A story: 10 years of searching without clarity, what disease is this?
Allison Fite is a girl who complains of sinusitis that doesn't go away. He complained about asthma, lost his sense of smell and taste. He also can't enjoy parties with his friends because when he drinks alcohol even a little, he experiences tremendous headaches.
Various doctors have been met, when they went to an allergy specialist and were tested for allergies, the results were negative. "You have no allergies," said the doctor,
Then a polyp appeared on his nose. The first operation was performed when he was 20 years old, then at 25 years old the second operation was performed because the polyps reappeared. Worse, after 8 weeks of surgery, the polyps reappeared.
Until one day Fite's mother found a page on the website that discussed a clinical presentation, exactly what Fite had: asthma, nasal polyps, and another one she didn't realize was a pseudo allergic reaction to aspirin. No doubt, his doctor at the time said Fite's disease was aspirin-exacerbated respiratory disease (AERD) or recurrent respiratory disease due to aspirin side effects.
Ten years of suffering from an incomprehensible disease, finally this test was conducted. The doctor gave him one-fifth of the aspirin tablet, just to see what would happen. And guess what happened 45 minutes later at Fite?
Fite experienced coughing, sweating, weakened blood pressure, until finally, "OK, you have AERD," said the doctor.
What is aspirin or AERD-generated respiratory disease?
AERD or also known as Samter's Triad is a chronic medical condition caused by the side effects of taking aspirin. This condition is characterized by the following symptoms:
- asthma
- sinus disease in the presence of recurrent polyps
- pseudoallergic reactions (pseudoallergies) to aspirin or other NSAIDs
Nasal polyps usually grow back quickly after surgery. This reaction is said to be pseudoallergic because it does not involve the formation of IgE as occurs in true allergic reactions. Approximately 10-20% of adult patients with asthma and 30-40% of patients with asthma and nasal polyps have AERD. More women reported this disease than men.
If a person tests positive for AERD, then after ingesting aspirin or another NSAID, he or she will experience the following symptoms within 30 minutes to 3 hours later:
- nasal symptoms such as congestion and runny nose
- eye symptoms such as swelling around the eye and conjunctivitis (redness of the eye)
- asthmatic symptoms such as wheezing, shortness of breath, coughing, and tightness in the chest.
Aspirin side effect reactions in this case may be more severe, namely with facial erythema, laryngospasm (short spasm of the vocal cords and causing difficulty speaking or breathing temporarily), abdominal cramps, epigastric pain, and hypotension.
What drugs can trigger this disease besides aspirin?
Aspirin is only one of the causes of AERD, and there are a range of other drugs that can trigger similar diseases, namely NSAIDs (non-steroidal anti-inflammatory drugs) selective COX-1 (cyclooxygenase 1).
Drugs including COX-1 selective NSAIDs include piroxicam, endomethacin, sul action, tolmetin, ibuprofen, naproxen, fenoprofen, oxaprozine, mefenamic acid, flurbiprofen, diflunisal, ketoprofen, diclofenac, ketorolac, ethodolac, and nabutemon. Because AERD is not only caused by aspirin, the group of experts under EAACI / WAO is now calling it NERD (non-steroidal anti-inflammatory drugs-exacerbated respiratory disease).
AERD sufferers are recommended to avoid the above drugs, but in certain conditions when they need pain relief, AERD sufferers can use:
- paracetamol and salsalat
- celecoxib
How
Avoiding aspirin and COX-1 selective NSAIDs is the best way to avoid symptoms in people with AERD, but if this is not possible, then the recommended solution is to do it. desensitation.
Desensitation means giving aspirin at a certain dose followed by giving aspirin every day to maintain the desensity level. There are many considerations for determining the correct dosage for desensitation, and to do this you will need to visit an immunologist allergist.
