Nasal Challenge With 50mgs Of L-Aspirin For Diagnosis Of ASA Exacerbated Respiratory Disease

Abstract

The ASA exacerbated respiratory disease is an aggressive and continuous inflammatory disease of the airways. The diagnosis can be established with provocation test using increasing doses of ASA, the oral test has the higher sensitivity. We assigned three groups of 20 patients. Group 1 were patients with AERD, group 2 were patients with asthma and nasal polyps, and group 3 were healthy volunteers. We administrated 50 mgs of L-aspirin in each middle tourbinate and 30 minutes after we performed another spirometry and rhinomanometry, it was considered positive if the FEV1 felt down 20% or more or the nasal flow decreased 40% or more. At the same time we recorded the clinical changes in the patients With the clinical changes we had a sensibility of 38.2% and a specificity of 96.2%. If the FEV1 felt down at least 20% or more, it had a sensibility of 50% and a specificity of 96%, , and if the nasal flow felt down at least 40%, it had a sensitivity of 73.5% and a specificity of 96%, and if we had at least 1 positive result of the three parameters we had a sensitivity of 85% and a specificity of 96%. The intranasal challenge is a safe and practical study for the diagnosis of AERD, and has a sensitivity and specificity similar to the oral challenge without the hospitalizations and the risk of severe reactions