[Mild intermittent aspirin-induced asthma in a patient who became asymptomatic after removal of pet hamsters from home].
A 25-year-old woman was admitted to our hospital because of wheeze, dyspnea, nasal obstruction, epiphora, and ear fullness. These symptoms occurred 30 minutes after the intake of 200 mg of ibuprofen and 100 mg of norfloxacin, which had been prescribed by a local clinic for an upper respiratory tract infection. The patient had kept 20 hamsters indoors and a dog outside for 1 year and a half. During the 9 months prior to admission, she had experienced nocturnal asthmatic symptoms, which were controlled by oral theophylline on an as-needed basis. She had seasonal rhinitis, but no sinusitis or nasal polyps. Serum total IgE was 98 U/ml, and tests for specific IgE antibodies to hamster epithelium and dog epithelium were both positive (class 2). The provocative concentration of methacholine causing a 20% fall in FEV1 was 4.7 mg/ml. After removal of the hamsters from her home, the patient became asymptomatic without further medication, and her airway hyper-responsiveness was also alleviated. Although inhalation challenge with 5% tolmetin failed to induce a positive reaction, the diagnosis of aspirin-induced asthma was confirmed by single-blind oral challenge with 100 mg of ibuprofen. The patient exhibited mild airway responsiveness as well as mild sensitivity to nonsteroidal anti-inflammatory drugs, differing from the severe and intractable clinical features of typical aspirin-induced asthma.
Kawai
K
K
Department of Internal Medicine, Fujinomiya City General Hospital, Japan.
Shirai
T
T
Suzuki
K
K
Chida
K
K
Nakamura
H
H
D000328:Adult; D000485:Allergens / Q000276:immunology; D000818:Animals; D000829:Animals, Domestic; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D001249:Asthma / Q000139:chemically induced* / Q000276:immunology; D016535:Bronchial Hyperreactivity / Q000139:chemically induced / Q000276:immunology; D001985:Bronchial Provocation Tests; D006224:Cricetinae; D004285:Dogs; D004848:Epithelium / Q000276:immunology; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects*; D007073:Immunoglobulin E / Q000032:analysis
D000485:Allergens; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007073:Immunoglobulin E; D001241:Aspirin; D007052:Ibuprofen