title: The nose as a target organ in the diagnosis of severe aspirin-exacerbated respiratory disease.
abstract: BACKGROUND
  The nasal provocation test (NPT) with lysine aspirin is a useful tool in the diagnosis of aspirin-exacerbated respiratory disease (AERD), previously reffered to as Samter's disease. The aim of the present study focuses on methodological interventions to show the usefulness of the NPT with lysine aspirin in differentiating AERD patients from aspirin-tolerant asthma (ATA) patients to improve the diagnostic efficacy and minimize the risk for adverse reactions compared with the gold standard.
  
  
  METHODS
  Thirty AERD patients comprised the active study group while the control group consisted of 25 ATA patients. A combination of objective nasal aerodynamic response (i.e., nasal inspiratory flow and nasal inspiratory resistance) was evaluated by active anterior rhinomanometry and the subjective clinical nasal and extranasal symptoms (including forced expiratory volume) were monitored throughout the challenge.
  
  
  RESULTS
  Fifty-five NPTs were successfully completed: sensitivity, 87%; specificity, 100%; positive predictive value, 100%; negative predictive value, 86%; global efficacy, 92.72%. No severe adverse reactions were recorded.
  
  
  CONCLUSIONS
  The present NPT with lysine aspirin proved to be a safe, efficient, and a timesaving method in the diagnosis of patients with AERD, even in those with severe rhinitis-rhinosinusitis and/or recurrent nasal polyposis.
authors.affiliation: Servicio de Alergia, Hospital Universitario N.Sra. La Candelaria, Santa Cruz de Tenerife, Spain. glezruperto@gmail.com
authors.forename: Ruperto
authors.initials: R
authors.lastname: González-Pérez
authors.forename: Paloma
authors.initials: P
authors.lastname: Poza-Guedes
authors.forename: Ramón
authors.initials: R
authors.lastname: Vives-Conesa
mesh_terms: D000328:Adult; D001241:Aspirin / Q000009:adverse effects / Q000031:analogs & derivatives*; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology; D055963:Asthma, Aspirin-Induced / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D008239:Lysine / Q000009:adverse effects / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000378:metabolism; D009298:Nasal Polyps; D009299:Nasal Provocation Tests; D009666:Nose / Q000473:pathology*; D011237:Predictive Value of Tests; D012220:Rhinitis; D025363:Rhinomanometry; D012680:Sensitivity and Specificity; D012852:Sinusitis
chemical_list: D008239:Lysine; D001241:Aspirin; C010395:acetylsalicylic acid lysinate