Aspirin Intolerance Syndrome

Abstract

Approximately 10–20 percent of patients with asthma are intolerant to aspirin. In such patients, symptoms of bronchospasm or urticaria/angio-edema may occur within a few minutes to several hours after the ingestion of aspirin-containing compounds. The severity of aspirin-induced asthma ranges from mild attacks of bronchospasm to severe status asthmaticus, which can prove fatal. Aspirin intolerance (A.I.) syndrome occurs most frequently in middle aged women. In many patients the onset of aspirin-induced asthma is preceded by the appearance of nasal polyps. Several analgesics which are structurally unrelated to aspirin, such as indomethacin, ibuprofen and fenoprofen, may also induce symptoms similar to those of A.I. syndrome in aspirin-sensitive patients. Aspirin and many of these nonsteroidal anti-inflammatory agents are known to be inhibitors of prostaglandin synthetase. There is also a similar cross-reactivity between aspirin and tartrazine dye (FDC yellow #5), although the two chemicals are structurally unrelated. It is essential that patients with known intolerance to aspirin should avoid those drugs known to produce similar effects, and foods and beverages containing tartrazine dye.