Ertoy Karagol Hacer Ilbilge, Yilmaz Ozlem, Topal Erdem, Ceylan Alper, Bakirtas Arzu
Department of Pediatric Allergy and Asthma, Gazi University School of Medicine, Ankara, Turkey.
Department of Otorhinolaryngology-Head and Neck Surgery, Gazi University School of Medicine, Ankara, Turkey.
Int Forum Allergy Rhinol. 2015 May;5(5):392-8. doi: 10.1002/alr.21494. Epub 2015 Mar 6.
There has been no study investigating nonsteroidal anti-inflammatory drugs (NSAIDs)-exacerbated respiratory disease (NERD) exclusively in childhood. Therefore, in the current study, the authors aimed to evaluate the diagnostic features, clinical characteristics, and follow-up of adolescents diagnosed with NERD.
The patients who were consecutively diagnosed with NERD between January 2011, and November 2013, included in the study. Oral provocation test (OPT) with at least 2 different NSAIDs was used to confirm NSAID hypersensitivity in patients with underlying asthma/chronic rhinosinusitis/nasal polyps. All patients were followed regularly in 3-month intervals by the Pediatric Allergy and Otorhinolaryngology Department for asthma, allergic rhinitis, or chronic rhinosinusitis with or without nasal polyps.
A total of 10 adolescents with NERD were included in the study. The mean age of the patients at the time of diagnosis was 14.9 ± 1.5 years. Hives or angioedema accompanied respiratory complaints induced by NSAIDs. The mean duration of follow-up was 28.9 ± 12.4 months. All patients had asthma except 1 with asymptomatic bronchial hyperreactivity. Asthma of patients was well-controlled with moderate dose of inhaled corticosteroids. Chronic rhinosinusitis with or without nasal polyps developed in 2 patients. Aspirin desensitization was required in these 2 patients with recurrent nasal polyps.
NERD in childhood has much more favorable clinical characteristics and course than in adulthood. Few adolescents with NERD refer with typical chronic upper respiratory tract complaints. The asthma component seems to be mild and is well controlled in the short-term follow-up.
尚无专门针对儿童非甾体抗炎药（NSAIDs）诱发的呼吸道疾病（NERD）的研究。因此，在本研究中，作者旨在评估被诊断为NERD的青少年的诊断特征、临床特点及随访情况。
纳入2011年1月至2013年11月期间连续被诊断为NERD的患者。对患有潜在哮喘/慢性鼻-鼻窦炎/鼻息肉的患者，采用至少2种不同NSAIDs进行口服激发试验（OPT）以确认NSAIDs过敏。儿科过敏与耳鼻咽喉科对所有患者进行定期随访，间隔3个月，观察哮喘、过敏性鼻炎或伴有或不伴有鼻息肉的慢性鼻-鼻窦炎情况。
本研究共纳入10例患有NERD的青少年。诊断时患者的平均年龄为14.9±1.5岁。NSAIDs诱发的呼吸道症状伴有荨麻疹或血管性水肿。平均随访时间为28.9±12.4个月。除1例有无症状支气管高反应性外，所有患者均患有哮喘。患者的哮喘通过中等剂量吸入性糖皮质激素得到良好控制。2例患者出现了伴有或不伴有鼻息肉的慢性鼻-鼻窦炎。这2例复发性鼻息肉患者需要进行阿司匹林脱敏治疗。
儿童NERD的临床特征和病程比成人更有利。很少有患有NERD的青少年表现出典型的慢性上呼吸道症状。哮喘症状似乎较轻，在短期随访中得到良好控制。
