ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences
Aspirin-exacerbated respiratory disease
Other Resources UpToDate PubMed

Aspirin-exacerbated respiratory disease

Contributors: Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

The development of acute respiratory tract reactions (upper and lower) to cyclooxygenase-1 (COX-1) inhibitors in the setting of asthma, chronic rhinosinusitis, and nasal polyposis is referred to aspirin-exacerbated respiratory disease (AERD). It is also known as nonsteroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (NERD).

Exposure to COX-1 inhibitors does not initiate this inflammatory process but exacerbates it.

The clinical course develops over the course of years, beginning with rhinosinusitis, which becomes chronic and persistent, often with the development of nasal polyps. Patients subsequently develop asthma and then aspirin and other NSAID hypersensitivity.

The condition affects 0.6%-1.9% of the general population, though the prevalence is higher among diagnosed asthmatics and higher still (30%-40%) when patients with asthma, nasal polyposis, and chronic rhinosinusitis are assessed with aspirin provocation testing. The condition is never seen before puberty and is more prevalent in women than in men, with an average onset in the third decade of life.

Acute reactions to COX-1 inhibitors develop 30 minutes to 2 hours after exposure to the offending agent and are marked by bronchospasm, rhinorrhea, tearing, and in some cases skin rash. These reactions are based on dosage and the strength of the agent's COX-1 inhibition.

Codes

ICD10CM:
J70.8 – Respiratory conditions due to other specified external agents

SNOMEDCT:
10692681000119108 – Aspirin exacerbated respiratory disease

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

Subscription Required

References

Subscription Required

Last Reviewed:08/24/2017
Last Updated:08/24/2017
Copyright © 2021 VisualDx®. All rights reserved.
Aspirin-exacerbated respiratory disease
Print  
Aspirin-exacerbated respiratory disease : aspirin
Copyright © 2021 VisualDx®. All rights reserved.