Imokawa S, Sato A, Taniguchi M, Toyoshima M, Nakazawa K, Hayakawa H, Chida K
Second Department of Internal Medicine, Hamamatsu University, School of Medicine.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Sep;32(9):883-7.
A 54-year-old woman was admitted to our hospital because of an asthmatic attack. Her first asthma attack occurred when she was 53 years old. It was followed by a flu-like infection, and was preceded for one year perennial rhinitis and loss of the sense of smell. Symptoms were perennial, and unrelated to the seasons. Because these clinical findings resembled those of aspirin-induced asthma (AIA), an aspirin-DL-lysine i.v. challenge test was done. Cough, perspiration, and flushing was provoked within 15 min after aspirin-DL-lysine injection, but FEV1 did not change. Respiratory sounds were normal and no wheezing was audible. Other cyclooxygenase inhibitors (ketoprofen, sulpyrine and acetaminophen) provoked the same symptoms. Successively increasing doses of injected aspirin-DL-lysine resulted in complete tolerance to this stimulus. We propose that aspirin-induced cough without bronchoconstriction is a new type of aspirin hypersensitivity.
一名54岁女性因哮喘发作入住我院。她的首次哮喘发作发生在53岁时。发作前有类似流感的感染,且在此前一年一直患有常年性鼻炎和嗅觉丧失。症状常年存在,与季节无关。由于这些临床表现类似于阿司匹林诱发的哮喘(AIA),遂进行了阿司匹林 - DL - 赖氨酸静脉激发试验。注射阿司匹林 - DL - 赖氨酸后15分钟内引发了咳嗽、出汗和脸红,但第一秒用力呼气容积(FEV1)未改变。呼吸音正常,未闻及哮鸣音。其他环氧化酶抑制剂(酮洛芬、安乃近和对乙酰氨基酚)也引发了相同症状。逐渐增加注射的阿司匹林 - DL - 赖氨酸剂量导致对该刺激产生完全耐受性。我们提出,无支气管收缩的阿司匹林诱发咳嗽是一种新型的阿司匹林超敏反应。