title: Nonsteroidal anti-inflammatory drugs-exacerbated respiratory disease in adolescents.
abstract: BACKGROUND
  There has been no study investigating nonsteroidal anti-inflammatory drugs (NSAIDs)-exacerbated respiratory disease (NERD) exclusively in childhood. Therefore, in the current study, the authors aimed to evaluate the diagnostic features, clinical characteristics, and follow-up of adolescents diagnosed with NERD.
  
  
  METHODS
  The patients who were consecutively diagnosed with NERD between January 2011, and November 2013, included in the study. Oral provocation test (OPT) with at least 2 different NSAIDs was used to confirm NSAID hypersensitivity in patients with underlying asthma/chronic rhinosinusitis/nasal polyps. All patients were followed regularly in 3-month intervals by the Pediatric Allergy and Otorhinolaryngology Department for asthma, allergic rhinitis, or chronic rhinosinusitis with or without nasal polyps.
  
  
  RESULTS
  A total of 10 adolescents with NERD were included in the study. The mean age of the patients at the time of diagnosis was 14.9 ± 1.5 years. Hives or angioedema accompanied respiratory complaints induced by NSAIDs. The mean duration of follow-up was 28.9 ± 12.4 months. All patients had asthma except 1 with asymptomatic bronchial hyperreactivity. Asthma of patients was well-controlled with moderate dose of inhaled corticosteroids. Chronic rhinosinusitis with or without nasal polyps developed in 2 patients. Aspirin desensitization was required in these 2 patients with recurrent nasal polyps.
  
  
  CONCLUSIONS
  NERD in childhood has much more favorable clinical characteristics and course than in adulthood. Few adolescents with NERD refer with typical chronic upper respiratory tract complaints. The asthma component seems to be mild and is well controlled in the short-term follow-up.
authors.affiliation: Department of Pediatric Allergy and Asthma, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: Hacer Ilbilge
authors.initials: HI
authors.lastname: Ertoy Karagol
authors.affiliation: Department of Pediatric Allergy and Asthma, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Yilmaz
authors.affiliation: Department of Pediatric Allergy and Asthma, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: Erdem
authors.initials: E
authors.lastname: Topal
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Ceylan
authors.affiliation: Department of Pediatric Allergy and Asthma, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Bakirtas
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D055963:Asthma, Aspirin-Induced / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009298:Nasal Polyps / Q000139:chemically induced / Q000175:diagnosis*; D012189:Retrospective Studies; D012220:Rhinitis / Q000139:chemically induced / Q000175:diagnosis*; D012852:Sinusitis / Q000139:chemically induced* / Q000175:diagnosis*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: NERD; NSAIDs-exacerbated respiratory disease; adolescents; follow-up; nonsteroidal anti-inflammatory drug