BMJ  2004;328:1076 (1 May), doi:10.1136/bmj.328.7447.1076-a

Letter

Aspirin induced asthma

Clinical relevance of finding was not explained

The first 150 words of the full text of this article appear below.

EDITOR—The prevalence of aspirin induced asthma on oral provocation testing in the systematic review by Jenkins et al was determined at 21%, which is noticeably higher than verbal history (2-3%) and recent reviews (10%).1-3 The clinical relevance of this finding is not explained. What was the degree of bronchospasm? In how many patients was it easily reversed by a dose of inhaler?

Credit: BAYER AG

As anaesthetists we agree fully with the authors' recommendations about the dangers of giving non-steroidal anti-inflammatory drugs (NSAIDs) to patients with known sensitivity to aspirin. We also recognise that people with nasal polyps and asthma are at higher risk of aspirin sensitivity. It is the large proportion of patients who are left for whom we have an issue.

The recommendation to organise a test before administration would be difficult in the current NHS. The authors' guidelines recommend that anyone younger than 40 should . . . [Full text of this article]

Indu Sivanandan, clinical fellow anaesthetics

sindu@doctors.org.uk

Stephen M Robinson, consultant anaesthetist

Southmead Hospital, Bristol BS10 5NB


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Relevant Article

Systematic review of prevalence of aspirin induced asthma and its implications for clinical practice
Christine Jenkins, John Costello, and Linda Hodge
BMJ 2004 328: 434. [Abstract] [Full Text] [PDF]

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