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[Intranasal provocation with lysine acetylsalicylic acid]
M Wellbrock1, J Mertens, M Cornelius
1Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universität Kiel.
HNO
|December 1, 1993
Summary
Intranasal lysine-acetylsalicylic acid (ASA) provocation is a well-tolerated, outpatient method for diagnosing ASA intolerance in patients with nasal polyps. This nasal test can help determine if further oral ASA provocation is necessary.
Area of Science:
- Otolaryngology
- Allergy and Immunology
- Pharmacology
Background:
- Acetylsalicylic acid (ASA) intolerance is frequently linked to nasal polyps.
- Current oral and inhalation provocation tests are time-consuming, uncomfortable, and often require hospitalization.
Purpose of the Study:
- To evaluate the sensitivity, specificity, and tolerance of intranasal lysine-ASA provocation in patients with nasal polyps.
- To compare the intranasal method with the established oral ASA provocation procedure.
Main Methods:
- A cohort of 153 patients with nasal polyps underwent intranasal provocation with lysine-ASA.
- Two protocols were tested: a 40-minute test with 2 mg lysine-ASA and a 100-minute test with 2, 4, and 10 mg lysine-ASA.
- Results were compared to oral ASA provocation, with sensitivity and specificity calculated.
Main Results:
- The 40-minute intranasal test showed a sensitivity of 0.47 and specificity of 0.91.
- The modified 100-minute test demonstrated improved sensitivity (0.67) but slightly lower specificity (0.84).
- Most reactions were mild, limited to the upper respiratory tract, with only two patients experiencing bronchial asthma symptoms.
Conclusions:
- Intranasal lysine-ASA provocation is a valuable, well-tolerated, and time-efficient method for assessing ASA intolerance in nasal polyp patients.
- This outpatient procedure can effectively guide the decision for performing more intensive oral provocation tests.