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Rad Croatian Academy of Sciences and Arts. Medical sciences : Medical Sciences, Vol. 559 No. 64-65, 2023.

Case report, case study

https://doi.org/10.21857/m3v76t5eqy

Non-steroidal anti-inflammatory drugs exacerbated respiratory disease – a condition overlooked by anesthesiologist

Tea Pašalić ; University Hospital Centre Zagreb, Department of Anesthesiology, ICU and Pain Therapy, Zagreb, Croatia *
Anja Mandarić ; University Hospital Centre Zagreb, Department of Anesthesiology, ICU and Pain Therapy, Zagreb, Croatia
Marijana Žura ; University Hospital Centre Zagreb, Department of Anesthesiology, ICU and Pain Therapy, Zagreb, Croatia
Zrinka Orešković ; University Hospital Centre Zagreb, Department of Anesthesiology, ICU and Pain Therapy, Zagreb, Croatia
Sandra Morović ; Arsano Medical Group, Zagreb, Croatia

* Corresponding author.

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Abstract

NSAID-exacerbated respiratory disease (N-ERD) is a chronic eosinophilic, inflammatory disorder of the respiratory tract occurring in patients with asthma and/or chronic rhinosinusitis with nasal polyps (CRNwNP), symptoms of which are exacerbated by NSAIDs, including acetylsalicylic acid (ASA). The clinical reaction to NSAID develops within 30-180 min and it is manifested by upper and/or lower airway symptoms. The majority of N-ERD patients suffer from moderate to severe asthma. A diagnosis
of N-ERD is fundamentally based on the patient’s history. N-ERD is suspected in patients having a history of upper/lower respiratory reactions after ingestion of ASA/NSAIDs or suffering from asthma along with chronic rhinosinusitis and nasal polyps. In this paper 57 years old women with history of well controlled asthma, allergic rhinitis and allergy to ASA is presented. After surgical procedure of total knee arthroplasty, during intensive care unit (ICU) stay, ketoprofen was administrated. Soon after, the patient develops symptoms such as dyspnea with decreased oxygen saturation (SpO2) and heaviness in stomach followed by appearance of swelling and itching of elbows and feet. After administrated therapy patient’s condition was improved. NSAIDs are frequently used analgesics and antipyretics that should be used with caution in patients who suffer from asthma.

Keywords

Acetylsalicylic acid; Asthma; Chronic rhinosinusitis with nasal polyps; Non steroidal anti-inflammatory drugs exacerbated respiratory disease

Hrčak ID:

312747

URI

https://hrcak.srce.hr/312747

Publication date:

22.12.2023.

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