METHODS: A retrospective study using an electronic medical record for suspected AERD adult asthmatic patients that underwent aspirin provocation and/or desensitization with aspirin. All patients had nasal polyposis. Two protocols have been used for aspirin provocation test: a) nasal ketorolac and oral aspirin and b) only oral aspirin. The clinical characteristics, test positivity and type of aspirin‘s reaction were assessed.
RESULTS: Twenty-three patients, with a mean age of 51.3 years were included in this study. Five patients had allergic asthma. Mean FEV1 was 82.0% of predicted value. Eighteen patients (78.3%) presented bronchospasm and/or urticaria with NSAIDs. Five patients did not develop any reaction. Regardless of the protocol used, ten patients (43.5%) presented positive test, confirming AERD, and five of them (50.0%) were submitted to desensitisation with aspirin. Thirteen patients (56.5%) presented negative provocation test and 3 of them (13.0%), could not complete the investigation due to urticaria.
CONCLUSIONS: Patients with suspected AERD should be submitted to aspirin provocation to confirm the diagnosis. In this study, more than half of the patients presented negative test and a small percentage of them did not complete the provocation test due to cutaneous reaction to aspirin.