Objective

To phenotype patients with aspirin-exacerbated respiratory disease (AERD) according to the presence of atopy, urticaria and level of peripheral eosinophils.

Methods

This study included adult asthmatic patients with AERD followed up at a tertiary hospital. They were classified according to atopy and/or urticaria, assessing clinical and laboratorial differences among the groups in order to identify possible aggravating factors of the disease.

Results

We included 73 patients, 78.1% being female with a mean age of 54.0 years. Severe asthma was observed in 68.5% and respiratory exacerbation with dipyrone in 67.1% of these patients. They had median total serum IgE of 191.6 IU/mL, mean peripheral eosinophils of 718.5 cells/mm³, and 50.7% were atopic. Urticaria was observed in 32.9% of them, and exacerbations were more often triggered by dipyrone (p = .016). Atopic patients were younger than nonatopic patients (p = .023), and had, on average, higher total serum IgE levels (p = .022). We observed a good correlation between asthma severity and peripheral eosinophils count (r² = 026; p = .021).

Conclusions

In this study, severe asthma was highly prevalent in AERD patients. Likewise, urticaria was quite prevalent and its presence was associated with dipyrone induced hypersensitivity reaction. Atopy was found in half of the patients, with no association with asthma severity. Patients with higher levels of peripheral eosinophils had more severe asthma. Dypirone hypersensitivity may be a marker for concomitant respiratory and cutaneous hypersensitivity reactions.

中文翻译：

---

阿司匹林加重的呼吸系统疾病患者对潘生酮的超敏反应与荨麻疹有关。

目的

根据特应性，荨麻疹和周围嗜酸性粒细胞水平的存在，对阿司匹林加重呼吸道疾病（AERD）的表型患者进行表型分析。

方法

这项研究纳入了成人哮喘患者并在一家三级医院进行了AERD随访。根据特应性和/或荨麻疹对它们进行分类，评估各组之间的临床和实验室差异，以确定可能加重疾病的因素。

结果

我们纳入了73名患者，其中78.1％为女性，平均年龄为54.0岁。在这些患者中，有68.5％的患者患有严重的哮喘，使用双嘧达隆可导致呼吸道急性发作。他们的中位血清总IgE为191.6 IU / mL，平均外周嗜酸性粒细胞为718.5细胞/ mm ³，特异反应率为50.7％。在其中有32.9％的人患有荨麻疹，而且双嘧达隆可加剧荨麻疹（p = .016）。特应性患者比非特应性患者年轻（p = .023），平均总血清IgE水平较高（p = .022）。我们观察到哮喘严重程度与外周嗜酸性粒细胞计数之间存在良好的相关性（r ²  = 026； p = .021）。

结论

在这项研究中，严重的哮喘在AERD患者中非常普遍。同样，荨麻疹非常普遍，其存在与双嘧啶引起的超敏反应有关。在一半的患者中发现了特应性，与哮喘的严重程度无关。外周嗜酸性粒细胞水平较高的患者患有更严重的哮喘。Dypirone超敏反应可能是伴随的呼吸道和皮肤超敏反应的标志物。