Prevalence of cross-sensitivity with acetaminophen in aspirin-sensitive asthmatic subjects☆,☆☆,★
Section snippets
Subjects
Seventy aspirin-sensitive adult asthmatic patients comprised the study population. Patients selected for acetaminophen challenge were those who came to Scripps Clinic and Research Foundation for evaluation and treatment of possible aspirin-sensitive respiratory disease. All 70 patients had a history compatible with aspirin-induced bronchospasm. In 50 patients (group 1), aspirin sensitivity was documented by means of oral aspirin challenges.6 Group 2 consisted of 20 asthmatic patients who,
RESULTS
Challenge results for both group 1 and group 2 patients are shown in Table II. Group 1 asthmatic patients, when challenged with aspirin in doses of 30, 60, and 100 mg, experienced the usual spectrum of responses, with 16 patients experiencing naso-ocular reactions without bronchospasm and 34 experiencing bronchospastic reactions. Group 2 patients did not react to aspirin. Within the subcategories of positive reactions to aspirin, acetaminophen cross-reactions are noted, with a clustering of
DISCUSSION
Delaney4 and Falliers5 reported conflicting data regarding the prevalence of acetaminophen cross-sensitivity in the aspirin-sensitive asthmatic subjects who were challenged with acetaminophen. In both studies patients were challenged with 1000 mg of acetaminophen. Delaney4 reported a cross-sensitivity of 29% (12 of 42), as opposed to the 0% (0 of 15) prevalence reported by Falliers.5
Overestimation bias in the study by Delaney4 might have resulted from several aspects of the design. The criteria
Acknowledgements
We gratefully acknowledge the efforts of the research nurses in the General Clinical Research Center at Scripps Clinic and Research Foundation as well as James A. Koziol, biostatistician for the General Clinical Research Center. The invaluable assistance of Mrs. Jeanine Anderson in the preparation of this manuscript is also acknowledged.
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Cited by (0)
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From the Division of Allergy and Immunology, Scripps Clinic and Research Foundation, La Jolla.
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Supported by General Clinical Research Center grant M01RR-00833, by a Scripps Clinic and Research Foundation grant, and by National Institutes of Health Allergy Disease Center grant AI-10386.
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Reprint requests: D.D. Stevenson MD, Division of Allergy and Immunology, Scripps Clinic and Research Foundation, 10666 North Torrey Pines Rd., La Jolla, CA 92037.