Amalgam allergy associated with exacerbation of aspirin-intolerant asthma.
BACKGROUND
Aspirin-intolerant asthma can be induced not only by acidic analgesics (including acetylsalicylic acid), which effectively inhibit cyclo-oxygenase, but also by cross-reactivity with paraben, and other chemical additives.


OBJECTIVE
We examined whether amalgam allergy is involved in the pathogenesis of a aspirin-intolerant asthma.


METHODS
We present the first case of aspirin-intolerant asthma that improved after the removal of dental amalgam. In addition, we performed both the methacholine provocation testing and sulpyrine provocation testing before and after the removal of dental amalgam.


RESULTS
In addition, the methacholine concentration causing a 20% fall in FEV1 in provocation tests rose significantly, though hypersensitivity to analgesics evaluated with sulpyrine provocation testing did not decrease. These results suggest that amalgam sensitization is involved in bronchial hyperresponsiveness in aspirin-intolerant asthma.


CONCLUSIONS
Sensitivity to amalgam may cause exacerbation of aspirin-intolerant asthma in some patients. To the best of our knowledge, this is the first case report of amalgam allergy associated with aspirin-intolerant asthma.
Yoshida
S
S
Dental Allergy Research Group, Clinical Research Division, AOKI International Medical Center, Yokohama, Japan.
Mikami
H
H
Nakagawa
H
H
Hasegawa
H
H
Onuma
K
K
Ishizaki
Y
Y
Shoji
T
T
Amayasu
H
H
D000328:Adult; D001241:Aspirin / Q000009:adverse effects*; D001249:Asthma / Q000175:diagnosis / Q000209:etiology*; D016535:Bronchial Hyperreactivity / Q000139:chemically induced / Q000175:diagnosis; D003723:Dental Amalgam / Q000009:adverse effects*; D004177:Dipyrone; D005260:Female; D006801:Humans; D016210:Methacholine Chloride; D012882:Skin Tests
D016210:Methacholine Chloride; D004177:Dipyrone; D003723:Dental Amalgam; D001241:Aspirin