• Aspirine asthma in children — not a rare form of disease
To content

Aspirine asthma in children — not a rare form of disease

SOVREMENNAYA PEDIATRIYA.2015.8(72):99-106; doi 10.15574/SP.2015.72.99 

Aspirine asthma in children — not a rare form of disease 

Оkhotnikova Е. N., Duda L. V., Shklyarska G. V.

P.L.Shupik National Medical Academy of Postgraduate Education

The National Children's Specialized Hospital «OKHMATDET», Kiev, Ukraine 

The article provides information about the basic features of aspirin-induced asthma in children. It is shown that the prevalence of intolerance to aspirin, nonsteroidal anti-inflammatory drugs or food salicylates in children with asthma varies widely — from 3 to 28%. Aspirin asthma is mainly seen at school age. The main link in the pathogenesis of aspirin intolerance is a blockade of the cyclooxygenase pathway of arachidonic acid metabolism, leading to its lipoxygenase pathway with the release of the active inflammatory mediators, the leukotrienes, which number is much higher than their levels in normal bronchial asthma. The first symptoms of aspirin intolerance may include sneezing, runny or stuffy nose and facial flushing, occurring in 1–3 hours after administration. Aspirin asthma is characterized by severe flow, and its attack can be life threatening. In severe cases, it appears with nasal polyps, continuous sinusitis and loss of olphaction. In time the half of the patients with polypous rhinosinuitis begin to respond to aspirin administration with the development of suffocation, its first attacks often occur after polypectomy and radical surgery of the paranasal sinuses. In some cases polyposis injures other mucous membranes — of the stomach, genitourinary system etc. The most common type of the disease in children is a combination of atopic asthma with intolerance to aspirin and its analogs. The most often debut of «aspirin triad» is perennial rhinitis, in 25% of patients it's polypous rhinosinusopathy, and its main symptoms are runny nose, nasal congestion, decreased or absent sense of smell, pain in the projection of the paranasal sinuses, and headache. Over time, appear the episodes of asphyxia, what is more the bronchospasm in response to aspirin develops in 10–30 minutes or a few hours and can be accompanied by the appearance of urticaria, dyspepsia, and in severe cases by anaphylactic shock and asphyxial syndrome. 

Кey words: aspirine intolerance, asthma, diagnostics, treatment, children. 

REFERENCES

1. Балаболкин ИИ, Мачарадзе ДШ. 1999. Аспириновая бронхиальная астма у детей. Аллергология. 4: 29—31.

2. Богорад АЕ. 2009. Семейная форма аспириновой астмы. Трудный пациент. 9: 35—38.

3. Геппе НА. 2008. Бронхиальная астма у детей. Стратегия лечения и профилактика. Национальная программа «Бронхиальная астма у детей. Стратегия лечения и профилактика». 3-е изд, испр и доп. Москва, Издательский дом «Атмосфера»: 108.

4. Зайков СВ, Міхей ЛВ. 2011. Особливості клініки, діагностики та лікування аспіринової бронхіальної астми. Новости медицины и фармации. 380: 3—5.

5. Каганов СЮ, Круглый БИ. 1988. Аспириновая астма у детей. Педиатрия: 56—60.

6. Княжеская НП. 2000. Аспириновая бронхиальная астма и антагонисты лейкотриенов. РМЖ. 12 (Пульмонология. Фтизиатрия, № 505). http://www.rmj.ru/articles_1639.htm

7. Ласица ОИ, Ласица ТС. 2001. Бронхиальная астма в практике семейного врача. Киев: 144—148.

8. Мачарадзе ДШ. Ацетилсалициловая кислота и астма: педиатрические аспекты. Лечащий врач. №03/04. http://www.lvrach.ru/2004/03/4531155/

9. Delillier P, Bacard N, Advenier C. 1999. Leukotriens, leukotrien receptor antagonits and leukotriene synthesis inhibitors in asthma: an update. Part II. Pharmacol Res. 40; 1: 15—29.

10. Eriksson J, Ekerljung L, Bossios A et al. 2015. Aspirin-intolerant asthma in the population: prevalence and important determinants. Clin Exp Allergy. 45(1): 211—219. http://dx.doi.org/10.1111/cea.12359.

11. Global Initiative for Asthma. A Guide for Health Care Professionals, Revised 2014. http://www.ginasthma.org

12. Gohil U, Modan A, Gohil P. 2010. Aspirin Induced Asthma — a Review. Global Journal of Pharmacology. 4(1): 19—30.

13. McMains KC, Kountakis SE. 2006. Medical and surgical considerations in patients with Samter's triad. American Journal of Rhinology. 20; 6: 573—576.

14. Mehta РN. 2000. Montelukast in Childhood Asthma. Indian Pediatrics. 37: 1201—1209.

15. Varghese M, Lockey R. 2008. Aspirin-Exacerbated Asthma. Allergy Asthma Clin Immunology. 4; 2: 75—83.