Abstract
Aspirin-induced asthma (AIA) is a severe and difficult-to-treat allergic disease in which acute asthma attacks are induced by nonsteroidal anti-inflammatory drugs. Patients with AIA rarely experience asthma attacks when taking celecoxib, a specific inhibitor of cyclooxygenase (COX) 2. A 33-year-old woman had a severe asthma attack with hypoxia and lost consciousness after oral provocation testing with 15 mg of aspirin and also with 50 mg of celecoxib. After 2 months of treatment with 10 mg/day of oral prednisolone, 1600 μg/day of inhaled fluticasone propionate, montelukast as a leukotriene receptor antagonist (LTRA), and long-term beta-agonist, we again challenged her with a provocation test with up to 200 mg of celecoxib; this time there were neither allergic symptoms nor decrease in forced expiratory volume in 1 second. Patients with severe or poorly controlled asthma may experience asthma attacks even if using selective COX-2 inhibitors. However, treatment with steroids and an LTRAs may inhibit asthma attacks induced by celecoxib.
MeSH terms
-
Acetates / therapeutic use
-
Administration, Oral
-
Adrenergic beta-Agonists / therapeutic use
-
Adult
-
Androstadienes / therapeutic use
-
Aspirin / administration & dosage
-
Aspirin / adverse effects*
-
Asthma, Aspirin-Induced / diagnosis*
-
Asthma, Aspirin-Induced / drug therapy*
-
Asthma, Aspirin-Induced / immunology
-
Asthma, Aspirin-Induced / physiopathology
-
Celecoxib
-
Cross Reactions
-
Cyclooxygenase 2 Inhibitors / administration & dosage
-
Cyclooxygenase 2 Inhibitors / adverse effects*
-
Cyclopropanes
-
Female
-
Fluticasone
-
Humans
-
Hypoxia
-
Immunization
-
Leukotriene Antagonists / therapeutic use
-
Prednisolone / therapeutic use
-
Pyrazoles / administration & dosage
-
Pyrazoles / adverse effects*
-
Quinolines / therapeutic use
-
Respiratory Function Tests
-
Sulfides
-
Sulfonamides / administration & dosage
-
Sulfonamides / adverse effects*
Substances
-
Acetates
-
Adrenergic beta-Agonists
-
Androstadienes
-
Cyclooxygenase 2 Inhibitors
-
Cyclopropanes
-
Leukotriene Antagonists
-
Pyrazoles
-
Quinolines
-
Sulfides
-
Sulfonamides
-
Prednisolone
-
Fluticasone
-
Celecoxib
-
montelukast
-
Aspirin