Aspirin-Exacerbated Respiratory Disease

Definition

Aspirin-exacerbated respiratory disease (AERD), also known as Samter's triad, is a chronic medical condition characterized by the development of asthma, chronic rhinosinusitis with nasal polyps, and sensitivity to aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs). It is a complex disorder that involves the immune system and inflammatory pathways, leading to respiratory symptoms that can be triggered by exposure to aspirin or other NSAID medications.

5 Must Know Facts For Your Next Test

1. AERD typically develops in adulthood, with the average age of onset being around 34 years old.
2. The underlying cause of AERD is not fully understood, but it is believed to involve a complex interplay between genetic, environmental, and immunological factors.
3. Exposure to aspirin or other NSAIDs can trigger the release of inflammatory mediators, leading to the exacerbation of asthma, nasal congestion, and other respiratory symptoms in individuals with AERD.
4. Patients with AERD often require a combination of medications, including corticosteroids and leukotriene modifiers, to manage their symptoms.
5. Aspirin desensitization therapy, in which patients are gradually exposed to increasing doses of aspirin, can be an effective treatment option for some individuals with AERD, allowing them to tolerate aspirin and other NSAIDs.

Review Questions

• Describe the key clinical features of aspirin-exacerbated respiratory disease (AERD).
  • The key clinical features of AERD include the triad of asthma, chronic rhinosinusitis with nasal polyps, and sensitivity to aspirin and other NSAIDs. Patients with AERD often experience recurrent episodes of wheezing, shortness of breath, nasal congestion, and sinus inflammation that can be triggered by exposure to aspirin or other NSAID medications. The underlying mechanism involves a complex interplay between the immune system and inflammatory pathways, leading to the exacerbation of respiratory symptoms.
• Explain the role of aspirin and other NSAIDs in the pathogenesis of AERD.
  • In individuals with AERD, exposure to aspirin and other NSAIDs can trigger the release of inflammatory mediators, such as leukotrienes, which contribute to the exacerbation of asthma, nasal congestion, and other respiratory symptoms. NSAIDs inhibit the activity of cyclooxygenase enzymes, leading to a shift in the balance of prostaglandins and leukotrienes, which are key players in the inflammatory response. This imbalance in eicosanoid production is believed to be a central mechanism in the development of AERD.
• Evaluate the management strategies for patients with aspirin-exacerbated respiratory disease, including the role of aspirin desensitization therapy.
  • The management of AERD typically involves a combination of medications, including corticosteroids and leukotriene modifiers, to control the underlying inflammation and manage respiratory symptoms. In some cases, aspirin desensitization therapy can be an effective treatment option. This approach involves gradually exposing the patient to increasing doses of aspirin, with the goal of desensitizing the immune system and allowing the patient to tolerate aspirin and other NSAIDs. Aspirin desensitization therapy can be a valuable intervention for AERD patients, as it can improve their quality of life and reduce the need for chronic medication use. However, this therapy requires close medical supervision and monitoring due to the potential risks associated with the initial exposure to aspirin.

Related terms

Asthma: A chronic inflammatory disorder of the airways that causes recurring episodes of wheezing, breathlessness, chest tightness, and coughing.

Chronic Rhinosinusitis: A condition characterized by persistent inflammation and swelling of the nasal and sinus cavities, leading to symptoms such as nasal congestion, facial pain, and decreased sense of smell.

Nasal Polyps: Noncancerous growths that develop in the nasal and sinus cavities, often as a result of chronic inflammation, and can contribute to nasal obstruction and other respiratory symptoms.