Diagnostic value of lysine-aspirin bronchoprovocation test for aspirin-sensitive asthma
아스피린-과민성 천식 : Lysine-aspirin 기관지유발시험의 진단적 유용성
박, 해심; 김, 윤정; 김, 희연; 남, 동호; 윤, 윤보
Alrerugi, 17(2):171-179, 1997
Alrerugi; Journal of the Korean Society of Allergology; Korean Journal of Allergy; 알레르기
Aspirin(ASA) and NSAIDs can induce bronchoconstriction in 10∼20% of adult
asthmatics patients. Inhalation of lysine-ASA(L-ASA) has been described as an
alternative method for diagnosis of ASA-sensitive asthma. To further understand the
characterlstics of ASA-sensitive asthmas. we studied 38 asthmatic patients with ASA
-sensitivity (36 intrinsic and 2 extrinsic asthma) proven by L-ASA bronchoprovocation
Most were female (male to female ratio was 27:73). Twenty (53%) of them had no
previous history of adverse reactions when exposed to ASA. Twenty nine (79%) had
rhino-sinusitis symptoms. Early asthmatic response was observed in 16 (42%) patients,
late only response in 16(42%), and dual response in 6(16%) patients. The threshold of L-ASA to provoke a positive response ranged from 11.2 to 180 ㎎/㎖ and most (68.3%) had a positive response after the inhalation of 180 ㎎/㎖. Concurrent sensitivity to sulfite was noted in 14 (36%) patients, followed by sensitivity to tartrazine in one (3%) patient.
None showed a positive response to sodium benzoate. After the avoidance from ASA/
NSAIDs with administration of anti-asthmatic medications, symptom and medication
scores reduced in 26(87%) patients among 30 followed patients. They were classified
into the improved group: four (13%) patients belonged to the not-improved group. There
were no significant differences in clinical characteristics between the improved and not-improved group (p>0.05).
In conclusion, L-ASA BPT could be considered as a useful method to diagnose ASA
-sensitive asthma and be used to screen the causative agent for asthmatic patients with
intrinsic type, especially in female patients with rhino-sinusitis and/or nasal polyp, even though they do not have arty history of adverse reactions. Cessation of exposure and proper treatment may allow to reduce symptom and medication scores.
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