The incidence of analgesics intolerance in asthmatic children detected by history and inhalation challenge with lysine acetylsalicylate.

To determine the incidence of adverse reactions to analgesics in unselected asthmatic children, histories were obtained from 486 children, using questionnaires and interviews. Mean age was 11.4 +/- 2.3 (+/- 1 SD) years (range 6-17 years), and mean duration of disease was 7.6 +/- 3.6 (1-15) years. The majority of 21 children gave an equivocal history, and only 7 (1.4%) of all children had a reliable history of adverse reactions to various analgesics. Inhalation challenge with increasing doses of lysine acetylsalicylate (LASA) was performed in 75 randomly selected asymptomatic children. Two boys of these (2.7%) had a positive test, defined as a 25% or more decrease of FEV1 and/or a 50% or more increase of the oscillatory airway resistance, compared with base line values. Both children had a mild airway obstruction, and had no personal or family history of analgesics intolerance. Further 27 children with suspected positive personal or family histories were also challenged. One girl of these manifested a mild urticaria; her pulmonary function remained unchanged. The incidence of analgesics intolerance in unselected asthmatic children is much lower than that of 12.5% to 28% reported in severe chronic asthma. The inhalation challenge with LASA proved simple, safe, effective and time saving, and thus, it offers an alternative method to the oral challenge in suspected children.