INTRODUCTION AND TERMINOLOGY
Aspirin exacerbated respiratory disease (AERD) refers to the combination of:
- Chronic rhinosinusitis (CRS) with nasal polyposis
- Reactions to aspirin (acetylsalicylic acid, ASA) and other COX-1 inhibiting nonsteroidal antiinflammatory drugs (NSAIDs), in which symptoms typically begin 30 minutes to 3 hours after ingestion and typically involve bronchospasm and nasal congestion
Patients with AERD are also described as having aspirin-sensitive asthma or aspirin intolerance, although these terms refer to just one component of the disorder. The term AERD places emphasis on the upper and lower respiratory disease as the fundamental disorder and NSAIDs as an exacerbating factor rather than the underlying cause [1,2]. In keeping with this, avoidance of NSAIDs by these patients does not result in resolution of asthma or CRS.
The first case of aspirin sensitivity in a patient with asthma was described in 1902, a few years after the introduction of aspirin into clinical use. In 1968, Samter and Beers described a triad consisting of asthma, aspirin sensitivity, and nasal polyps , which came to be known as Samter's triad.
In this topic review, the term NSAID includes aspirin (ASA). However, in some parts of this topic, aspirin is discussed exclusive of other NSAIDs.