Aspirin bronchial asthma is a pathological condition belonging to the pseudoallergy group. The basis of the development of this disease is the increased sensitivity of the body to acetylsalicylic acid and other medicines from the group of nonsteroidal anti-inflammatory drugs. From a clinical point of view, this pathology is manifested by a spasm of the bronchial wall, which leads to a narrowing of the bronchial lumen and impaired respiratory function. In addition, there are often other specific signs that are characteristic of the violation. The prognosis for this pathological process directly depends on the severity of the occurring seizures and the individual characteristics of the organism.
For the first time, a specific reaction by type of allergy to taking aspirin was described as early as nineteen hundred and three. On that moment acetylsalicylic acid used in medical practice for four years. In nineteen fifth year, two cases of asphyxiation after taking this drug were recorded.According to statistics, among all forms bronchial asthma aspirin forms account for about twenty percent. Most often, the disease occurs in the age range of thirty to fifty years. In this case, women are somewhat more susceptible to its development.
As we have said, the main causative factor for the occurrence of such a disease is aspirin and other representatives of non-steroidal anti-inflammatory drugs. It is believed that salicylates and polycyclic acids are the most active in this regard, for example, indomethacin. It is worth noting that in more than fifty percent of cases, in the presence of aspirin hypersensitivity, a similar reaction will be to other drugs. How intensely the pathological reaction will be expressed directly depends on the route of administration of the drug, as well as on its dosage. The most severe is an attack of bronchial asthma with the parenteral flow of the drug into the body.
In addition, bronchial obstruction is often caused not only by drugs, but also by natural salicylates. Products containing a large amount of salicylates include cherries, tangerines, green peppers and olives, almonds, peanuts, and more. Some spices also contain a certain amount of these substances. Sometimes this disease develops even with the use of canned food, which include salicylic and benzoic acids.
It is believed that a hereditary predisposition plays a role in the occurrence of this pathological process. The first familial case, presumably due to an autosomal dominant mode of inheritance, was described in nineteen seventy-four. It is worth noting that aspirin bronchial asthma is not formed because of the classic allergic reaction. Its occurrence is associated with impaired metabolism of omega-6-unsaturated fatty acid, called arachidonic. Against this background, there is an active production of inflammatory mediators, causing an increase in vascular permeability and excessively intense secretion of bronchial mucous exudate. The bronchi themselves are directly spasmed, and the mucus produced violates their patency even more.
In addition to the above, several quite complex mechanisms are involved in the development of aspirin-induced bronchial asthma, the outcome of which is a pronounced impairment of respiratory function.
Symptoms for aspirin bronchial asthma
There are several options for the course of this pathological process. Most often in the clinical picture there are several specific symptoms. About half an hour or an hour after taking a nonsteroidal anti-inflammatory drug, a sick person begins to complain of nasal congestion, copious discharge of mucous exudate from it, as well as tears. On examination, you can find that the patient’s face is hyperemic. There is intense sneezing and headaches. After some time, a classic attack of suffocation develops, characterized by difficulty in exhalation.
In some cases, parallel symptoms such as abdominal tenderness, nausea and vomiting attacks increase. A sick person has dizziness and decreases blood pressure.
Another variant of this disease is called isolated. In addition to suffocation, no clinical manifestations are detected anymore. This option is considered to have a relatively favorable outlook.
Often this pathological condition is combined with hypersensitivity to other substances, such as plant pollen or food. In this case, there are often symptoms from not only the respiratory system, but also other organs. Very often, when examining a patient, diseases such as eczema, atopic dermatitis and so on.
Diagnosis and treatment of the disease
First of all, for the diagnosis of this disease, it is necessary to carefully collect anamnesis and trace the dependence of seizures on NSAIDs. It is mandatory to evaluate the function of external respiration. Confirmation of the diagnosis can be carried out using provocative tests carried out only in specialized medical institutions. However, this method is not recommended for widespread use due to possible risks.
Bronchial asthma is an indication for the administration of inhaled glucocorticosteroids, beta-adrenoreceptor agonists, as well as anti-leukotriene drugs. In some cases, anticholinergics are used to quickly relieve an attack. In severe cases of the disease, systemic corticosteroids are used.
Prevention of the development of aspirin bronchial asthma
Talking about prophylaxis this disease, we mean the prevention of exacerbations. To this end, it is necessary to avoid taking NSAIDs, as well as comply with all recommendations of the attending physician.