Aspirin-intolerance as a precipitating factor of life-threatening attacks of asthma requiring mechanical ventilation.
The records of 92 asthmatics who underwent mechanical ventilation were reviewed. In seven patients (8%) the severe attack was precipitated by a non-steroidal anti-inflammatory drug (NSAID); one of these patients died. Five of the cases had a history of asthmatic attacks provoked by NSAIDs; whilst in two the severe attack requiring mechanical ventilation was the first manifestation of NSAID-intolerance. In two patients the NSAID had been prescribed by their physicians. Another aspirin-intolerant patient, a general practitioner, self-administered a NSAID. The sudden attack in another patient was precipitated by a preparation which contains aspirin and is usually recommended for indigestion. In the fatal case the attack was provoked by a capsule containing aspirin, which had been given by a herbalist. Unlike other reports, we found that NSAID-intolerance is a frequent provoking factor in severe acute asthma requiring mechanical ventilation. Inadequate investigation of precipitating factors in asthmatics with severe sudden attacks is a possible reason why this phenomenon is underreported.
Picado
C
C
Servei de Pneumologia, Hospital Clinic, Facultad de Medicina, Barcelona, Spain.
Castillo
J A
JA
Montserrat
J M
JM
Agusti-Vidal
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D001249:Asthma / Q000139:chemically induced*; D004342:Drug Hypersensitivity / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013224:Status Asthmaticus / Q000139:chemically induced* / Q000628:therapy; D012122:Ventilators, Mechanical
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin