[Analgesic intolerance in asthmatic children]

Abstract

The different clinical presentations of analgesics-intolerance are presented in four asthmatic children. Analgesics-intolerance is rare in children and both sexes are equally affected. The affected children have either a severe mixed asthma and often a chronic sinusitis and nasal polyps, or a chronic urticaria. Often, the first manifestation occurs several years after onset of asthma and is triggered by respiratory infections. Ingestion of most analgesics may cause severe bronchial obstruction, urticaria, angioedema, collaps and rhinitis. The diagnosis can be established by an unequivocal history, or, in uncertain cases, by an inhalation challenge with lysin-acetylsalicylate. The best prophylaxis and therapy is to avoid all responsible drugs. The inhibitory effect of most analgesics on the cyclooxygenase initiates impairments in the metabolism of prostaglandins and leukotrienes, which are suspected to cause the bronchial obstruction in intolerant patients.