Aspirin Can Be an Unrecognized Asthma Trigger

Feb. 19, 2004 -- One in five asthma patients are sensitive to aspirin. Yet many are unaware that aspirin is an asthma trigger -- and that they are at risk of a potentially life-threatening reaction.

A new study analyzes 21 reports on aspirin-induced asthma both in adults and children.

"The prevalence of aspirin-induced asthma is 21% for adults and 5% for children," writes researcher Christine Jenkins, PhD, with the Woolcock Institute of Medical Research in Australia.

Her study appears in this week's British Medical Journal.

In her analysis, Jenkins found that about one-half of the adults had reactions to low doses of aspirin (80 milligrams or more), indicating they were highly sensitive.

Sensitivity to three additional commonly used pain relievers was also seen in asthmatic patients sensitive to aspirin -- ibuprofen, naproxen, and diclofenac. Ninety-eight percent were sensitive to 400-milligram doses or less of ibuprofen; 100% were sensitive to 100 milligrams or less of naproxen; and 98% were sensitive to 40 milligrams or less of diclofenac.

The syndrome is likely underdiagnosed and underreported, Jenkins explains because of the lack of routine testing in asthmatic patients. Patients often do not report aspirin sensitivity, she says.

Symptoms of an asthma episode can be mild to severe. They may include:

• Wheezing
• Coughing
• Chest tightness
• Rapid, shallow breathing or difficulty breathing
• Sleep disturbance
• Shortness of breath
• Tiring quickly during exercise

The authors suggest that anyone who is positively identified as having aspirin- induced asthma should avoid all NSAIDs and products that contain aspirin. NSAID's, nonsteriodal anti-inflammatory drugs, are a class of over-the-counter pain relievers that include aspirin and ibuprofen but do not include Tylenol.

They also say that anyone with asthma younger than 40 years of age should be informed about the risks of aspirin-induced asthma even if they have never had an incident. They say that it can develop later in life. If NSAIDs are necessary, they may be taken under medical supervision.

People who think that aspirin may be an asthma trigger for them should report it to their doctors, because it can be fatal. Aspirin-induced asthma is more common than previously suggested, write the authors.