title: The natural history and clinical characteristics of aspirin-exacerbated respiratory disease.
abstract: BACKGROUND
  Aspirin-exacerbated respiratory disease (AERD) is a clinical syndrome characterized by chronic rhinitis, nasal polyps, asthma, and precipitation of asthma and rhinitis attacks after ingestion of aspirin (ASA) and most nonsteroidal anti-inflammatory drugs (NSAIDs). Most information about the disease in the United States has come from small samples of patients.
  
  
  OBJECTIVE
  The purpose of this study was to examine the natural history and clinical characteristics of 300 AERD patients, referred to our institution for aspirin desensitization.
  
  
  METHODS
  All potential AERD patients were evaluated using a standard questionnaire that included information about clinical characteristics and natural progression of their disease, previous history of reactions to ASA and other NSAIDs, current use of medications, and ethnic backgrounds. All patients underwent oral ASA challenges to prove they had AERD.
  
  
  RESULTS
  From patients' history we found that the average age at onset of AERD was 34 years, and that 57% were female. Counting ASA as an NSAID, 33% had previously reacted on two occasions to NSAIDs and 36% on more than three occasions to NSAIDs, whereas only 27% had reacted to one NSAID before they came to us for evaluation. Our patients had averaged 5.5 episodes of sinusitis per year. There were no significant differences in the clinical characteristics or use of medications between genders. Ethnicity was heterogeneous in most participants.
  
  
  CONCLUSIONS
  AERD begins in the third decade of life and in both sexes. The disease progressed over the 13 years between historical onset and current evaluation, with more sinusitis and need for controller medications over time. There was no ethnic or familial distribution of AERD.
authors.affiliation: Scripps Clinic, La Jolla, California 92037, USA.
authors.forename: M Pilar
authors.initials: MP
authors.lastname: Berges-Gimeno
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Simon
authors.forename: Donald D
authors.initials: DD
authors.lastname: Stevenson
mesh_terms: D000208:Acute Disease; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D001249:Asthma / Q000139:chemically induced; D001985:Bronchial Provocation Tests; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000139:chemically induced; D012140:Respiratory Tract Diseases / Q000139:chemically induced* / Q000175:diagnosis; D012220:Rhinitis / Q000139:chemically induced; D016037:Single-Blind Method; D011795:Surveys and Questionnaires
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin