We report a case of
asthma that was relieved by
aspirin and other
cyclooxygenase inhibitors. The patient, a 51-year-old man, was admitted to our hospital because of an asthmatic attack. Onset of
asthma had occurred at the age of 40 years, after a flu-like
infection, and was preceded for several years by perennial
rhinitis and loss of the sense of smell. The course was perennial, and unrelated to the seasons. These clinical features resembled those of
aspirin-induced asthma (AIA). Therefore, suspecting AIA, we performed a
aspirin-DL-
lysine iv challenge test. After
aspirin-DL-
lysine injection, FEV1 was increased by about 30% and
nasal obstruction was improved. Other
cyclooxygenase inhibitors (
indomethacin,
mefenamic acid,
ketoprofen) also improved FEV1 by more than 30%.
Hydrocortisone sodium succinate (HCs) improved FEV1 about 20%.
Lipoxygenase inhibitor (
AA861) produced an evident attack, but continued administration did not result in complete tolerance. On the other hand, seven other AIA patients showed no reaction to
AA861. DSCG had an acute bronchodilative effect similar to that of AIA.
Paraben and
chloramphenicol sodium succinate (CMs) produced an asthmatic attack. The present patient showed a marked improvement in response to
cyclooxygenase inhibitors and HCs, in contrast to the situation in AIA, and developed an evident asthmatic attack in response to
lipoxygenase inhibitor. He showed marked improvement in the response to DSCG and developed an asthmatic attack in response to
paraben and CMs, as in AIA. Our results suggest an abnormality of
Arachidonic acid metabolism not only in AIA but also in
asthma relieved by
aspirin.(ABSTRACT TRUNCATED AT 250 WORDS)