The Challenge Of When To Challenge: An Investigation Into Aspirin-Exacerbated Respiratory Disease (AERD) Screening Methodology

Abstract

Aspirin-exacerbated respiratory disease(AERD), a phenotype of chronic rhinosinusitis with nasal polyposis(CRSwNP), has a distinct pathophysiology and therapeutic approach. NSAID allergy is a frequently unreported but essential AERD feature that leads to missed diagnoses. Aspirin challenge is the predominant practice for diagnosis of obscured AERD cases. Reports suggest a correlation between AERD and elevated markers including eosinophils, basophils, serum IgE and urine leukotriene E4(LTE4), but data is inconclusive. We sought to identify clinical screening markers for CRSwNP correlating with positive challenge and AERD diagnosis.