Aspirin intolerance. III. Subtypes, familial occurrence, and cross-reactivity with tartrazine

Abstract

Evidence has been presented supporting the hypothesis that at least 2 different types of mechanisms may be involved in aspirin intolerance, one resulting in bronchospasm and the other producing urticaria/angioedema. Bronchospasm is the predominant symptom of aspirin intolerance in patients who have asthma. In contrast, the predominant symptom of aspirin intolerance in patients who have rhinitis is urticaria/angioedema. In the bronchospastic type of aspirin intolerance, there is a significant correlation with an increased frequency of nasal polyposis, and with a similar ageonset of asthma and aspirin intolerance. These correlations were not present in the urticaria/angioedema type. Additional evidence for familial occurrence of aspirin intolerance is presented, and its relationship with subtypes of aspirin intolerance is discussed. In a double-blind, crossover study with normal control subjects matched by age and sex, 15% ( 6 40 ) of aspirin-intolerant individuals had significant adverse reactions to tartrazine challenge and not to the placebo. None of the 40 normal control subjects had any adverse reactions.