Aspirin triad, asthma association

Three years after introduction of aspirin into therapy, Hirschberg in Poznan, now in Poland, described the first case of a transient, acute angioedema/urticaria, occurring shortly after ingestion of aspirin. Reports of anaphylactic reactions to aspirin soon followed. The other major type of adverse reaction, acute bronchospasm, was described in the second decade of the 20th century. In 1920, Van der Veer reported the first death due to aspirin. The association of aspirin sensitivity, asthma and nasal polyps was first recorded by Widal in 1922. This clinical entity, later named the aspirin triad was popularized in 1968 by Samter and Beers [3], who presented a... 

The natural history of aspirin-induced asthma, or aspirin triad, begins with ihinorrhea and nasal congestion. This proceeds to rhinitis which becomes perennial and associated with chronic sinusitis and nasal polyps. Asthma develops 1-5 years after the onset of rhinitis. The disease usually appears at an age of 30-34 years and its course is usually more severe and progressive in women who outnumber men. 

In sensitive subjects, aspirin (and other NS AIDs) is associated with the so-called aspirin triad or aspirin-induced asthma (AIA also called aspirin-exacerbated respiratory disease). Classic AIA consists of chronic asthma and rhinosinus-itis together with nasal polyps. The incidence of AIA in adult asthmatics is about 3-5 %. 

The classic description of the aspirin-intolerant asthmatic includes the triad of severe asthma, nasal polyps, and aspirin intolerance. The typical patient experiences intense vasomotor rhinitis, which may or may not be associated with aspirin exposure, beginning during the third or fourth decade of life." Over a period of months, nasal polyps begin to appear, followed by severe asthma exacerbated by aspirin. 

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