Seventeen patients with aspirin-induced asthma were studied, the majority being intolerant to more than one analgesic. In addition to asthma, eleven patients had sinusitis and eight had nasal polyps. Serum IgE levels were normal with a mean of 295 iu/ml. However, some patients had positive cutaneous and PK tests against inhalants and non-analgesic drugs.
Spirometry showed the bronchial obstruction to be mild. However, all patients were hyper-reactive to acetylcholine. Oral provocation tests with aspirin alone and also with the prior administration of sodium cromoglycate (SCG) by inhalation were performed and the results assessed by spirometry and clinical examination.
The results suggest that the obstruction is probably due to oedema of the bronchial mucosa together with pulmonary congestion rather than a simple spasm of the bronchi.
SCG was found to prevent significantly the ventilatory obstruction induced by aspirin.
It is suggested that non-immunological factors are responsible for the asthma and that SCG may have an effect on the altered receptors protecting them from the action of aspirin on kinins.