아스피린 흡입 기관지 유발시험에서 후기 단독 양성 반응을 보인 아스피린 과민성 천식 1예
A Case of Aspirin Intolerant Asthma Presenting Late Only Response during the Lysine-aspirin Bronchoprovocation Test
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Aspirin and other non-steroidal anti-inflammatory agents (NSAIDs) cause bronchoconstriction in 10% to 20% of the adult asthmatic patients. The lysine-aspirin bronchial provocation test (L-ASA BPT) has become a widely used diagnostic test for detecting aspirin sensitivity in asthmatic patients. Several investigators have reported the development oflate and dual asthmatic responses as well as early asthmatic response. Most late asthmatic responses are known to occur within 4 to 6 hours of the L-ASA BPT. We report a case of aspirin-intolerant asthma with late only response during the L-ASA BPT. The late responses were notedtwice at 4 (greater than 20% decrease of FEV1) and 13 hours (greater than 30∼50% decrease of PFR with dyspnea) after the L-ASA BPT. In conclusion, we suggest that follow-up lung function monitoring will be needed for more than 12 hours after the L-ASA BPT to confirm delayed late asthmatic response.
Abstract
Aspirin and other non-steroidal anti-inflammatory agents (NSAIDs) cause bronchoconstriction in 10% to 20% of the adult asthmatic patients. The lysine-aspirin bronchial provocation test (L-ASA BPT) has become a widely used diagnostic test for detecting aspirin sensitivity in asthmatic patients. Several investigators have reported the development oflate and dual asthmatic responses as well as early asthmatic response. Most late asthmatic responses are known to occur within 4 to 6 hours of the L-ASA BPT. We report a case of aspirin-intolerant asthma with late only response during the L-ASA BPT. The late responses were notedtwice at 4 (greater than 20% decrease of FEV1) and 13 hours (greater than 30∼50% decrease of PFR with dyspnea) after the L-ASA BPT. In conclusion, we suggest that follow-up lung function monitoring will be needed for more than 12 hours after the L-ASA BPT to confirm delayed late asthmatic response.
참고문헌 (18)
- Sun-SinKim, "Enhanced Serum Neutrophil Chemotactic Activity was Noted in Both Early and Late Asthmatic Responses During Lysine-Aspirin Bronchoprovocation Test in ASA-Sensitive Asthmatic Patients", Journal of Korean Medical Science, 18(1), pp.42~47 (2003), 대한의학회
- Hong SP, "Oral provocation tests with aspirin and food additives in asthmatic patients", Yonsei Med J, 30, pp.339~45 (1989)
- Park HS, "Aspirin-sensitive asthma: recent advances in management", BioDrugs, 13, pp.29~33 (2000)
- Park HS KY, "Aspirin-intolerant Asthma: Usefulness of Lysine-aspirin inhalation bronchial provocation test", Korean J Asthma Allergy Clin Immunol, 17, pp.171~9 (1997)
- 이재영, "경증 및 중등증 천식 환자에서 아스피린 과민성의 유병률과 임상적 특성", 천식 및 알레르기, 22(1), pp.100~108 (2002), 대한천식알레르기학회
- Kim SS, "Changes of serum neutrophil chemotactic activity (NCA) and myeloperoxidase( MPO) level following lysine-aspirin (L-ASA) bronchoprovocation test in aspirin-sensitive asthmatic patients", J Asthma Allergy Clin Immunol, 19, pp.181~7 (1999)
- Szczeklik A, "Natural history of aspirin-induced asthma. AIANE Investigators. European Network on Aspirin-Induced Asthma", Eur Respir J, 16, pp.432~6 (2000)
- Lee BJ, "Relationship of eosinophils in induced sputum with bronchial responsiveness to methacholine or capsaicin and with responses to anti-asthmatic treatment in chronic cough patients", Korean J Asthma Allergy Clin Immunol, 20, pp.895~905 (2000)
- Bianco S, "Aspirin induced tolerance in aspirin-asthma detected by a new challenge test", J Med Sci, 5, pp.129~ (1977)
- Nizankowska-Mogilnicka E, "Aspirin provocation tests for diagnosis of aspirin hypersensitivity", Allergy, 62, pp.1111~8 (2007)
- Phillips GD, "Inhaled lysine-aspirin as a bronchoprovocation procedure in aspirin-sensitive asthma: its repeatability, absence of a late-phase reaction, and the role of histamine", J Allergy Clin Immunol, 84, pp.232~41 (1989)
- Babu KS, "Aspirin and asthma", Chest, 118, pp.1470~6 (2000)
- Nizankowska E, "The international symposium: Eicosanoid, Aspirin and ashtma", European Network on Aspirin- Induced Asthma Newsletter (1996)
- Sladek K, "Eicosanoids in bronchoalveolar lavage fluid of aspirinintolerant patients with asthma after aspirin challenge", Am J Respir Crit Care Med, 149, pp.940~6 (1994)
- Sladek K, "Eicosanoid levels in bronchoalveolar lavage fluid in aspirin-induced asthma patients after placebo and lysine aspirin inhalation", Am Rev Respir Dis, 147, pp.555~ (1993)
- Szczeklik A, "Bronchial aspirin challenge causes specific eicosanoid response in aspirin-sensitive asthmatics", Am J Respir Crit Care Med, 154, pp.1608~14 (1996)
- Siraganian RP, "Refinements in the automated fluorometric histamine analysis system", J Immunol Methods, 7, pp.283~90 (1975)
- Dente FL, "Relationship between serum heat-stable neutrophil chemotactic activity during early airway reaction to allergen and the pattern of airway response (early versus late reactions) in asthmatic subjects", Respiration, 64, pp.285~90 (1997)