[Aspirin hypersensitivity: characteristics and diagnostic approach].

Area of Science:

• Immunology
• Pulmonology
• Pharmacology

Background:

• Aspirin hypersensitivity (AH) diagnosis is difficult in routine practice.
• No reliable clinical features or biomarkers exist for AH confirmation.
• Oral provocation tests (OPT) for AH are infrequently performed.

Purpose of the Study:

• To compare asthmatic patients with and without aspirin hypersensitivity.
• To identify clinical characteristics differentiating asthmatics with AH.
• To investigate hematological changes following OPT in asthmatics.

Main Methods:

• Compared 21 asthmatics with AH to 24 without AH.
• Defined AH based on a positive oral provocation test (OPT).
• Performed full blood counts before and 24 hours after OPT.

Main Results:

• Medical history showed low sensitivity (52%) but high specificity (96%) for AH.
• AH was more prevalent in women, with higher allergic rhinitis frequency.
• AH patients had higher platelet counts; OPT induced decreased eosinophils and increased neutrophils.

Conclusions:

• AH diagnosis remains challenging, with limited diagnostic value of medical history.
• Blood count changes (eosinophils, neutrophils) post-OPT in AH patients warrant further study.
• Observed hematological shifts suggest a rapid pro-inflammatory role for aspirin.