Aspirin intolerance. II. A prospective study in an atopic and normal population

In a prospective study 1,372 patients with asthma and rhinitis and 808 normal individuals were directly questioned about symptoms of intolerance to aspirin. The frequency of aspirin intolerance in our asthmatic group was significantly greater (3.8 per cent) than the frequency in the rhinitis alone group (1.4 per cent) or in our normal group (0.9 per cent). There was no statistical difference of aspirin intolerance between rhinitis alone and our normal individuals. The predominant symptom of aspirin intolerance in our asthmatic group was bronchospasm, while the predominant symptom in our rhinitis alone group was urticaria. In our normal individuals, manifestations of aspirin intolerance were about equally divided between bronchospasm and urticaria. It appears that at least two possible pathogenic mechanisms may be present in aspirin intolerance, one producing bronchospasm and the other resulting in angioedema/urticaria.