Hussein A
Kinderkrankenhaus, Norderney.
Monatsschr Kinderheilkd. 1988 Mar;136(3):135-9.
The different clinical presentations of analgesics-intolerance are presented in four asthmatic children. Analgesics-intolerance is rare in children and both sexes are equally affected. The affected children have either a severe mixed asthma and often a chronic sinusitis and nasal polyps, or a chronic urticaria. Often, the first manifestation occurs several years after onset of asthma and is triggered by respiratory infections. Ingestion of most analgesics may cause severe bronchial obstruction, urticaria, angioedema, collaps and rhinitis. The diagnosis can be established by an unequivocal history, or, in uncertain cases, by an inhalation challenge with lysin-acetylsalicylate. The best prophylaxis and therapy is to avoid all responsible drugs. The inhibitory effect of most analgesics on the cyclooxygenase initiates impairments in the metabolism of prostaglandins and leukotrienes, which are suspected to cause the bronchial obstruction in intolerant patients.
本文介绍了4例哮喘儿童出现的镇痛药不耐受的不同临床表现。镇痛药不耐受在儿童中较为罕见,男女发病率相同。患病儿童要么患有严重的混合性哮喘,常伴有慢性鼻窦炎和鼻息肉,要么患有慢性荨麻疹。通常,首次表现出现在哮喘发作数年之后,且由呼吸道感染引发。摄入大多数镇痛药可能会导致严重的支气管阻塞、荨麻疹、血管性水肿、虚脱和鼻炎。明确的病史可确立诊断,在情况不明时,可通过赖氨酸 - 乙酰水杨酸吸入激发试验来诊断。最佳的预防和治疗方法是避免使用所有相关药物。大多数镇痛药对环氧化酶的抑制作用会引发前列腺素和白三烯代谢障碍,这被怀疑是导致不耐受患者支气管阻塞的原因。