[Analgesic intolerance (AI). Key position of ENT physicians for early detection of this condition]

HNO. 2008 Apr;56(4):443-50; quiz 451. doi: 10.1007/s00106-008-1701-6.
[Article in German]

Abstract

The clinical manifestation of analgesic intolerance (AI) is frequently associated with symptoms examined by ear-nose-throat (ENT) specialists. The prevalence of AI is reported in the literature to be 0.6-2.5%. Even though there are no concluding results concerning its pathogenesis, an altered arachidonic acid metabolism is most likely the underlying pathomechanism. The symptoms include chronic rhinosinusitis with nasal polyps, asthma, gastrointestinal ulcers, angioedema, and urticaria. Clinical reactions after ingestion of nonsteroidal anti-inflammatory-drugs (NSAIDs) are often obvious in the progress of disease. In order to initiate early therapy and therefore prevent the progress of disease, the diagnosis of AI should occur before the complete picture of AI is obvious. Adaptive desensitization is currently the single causal therapy. Frequency of endonasal revision surgery is reduced after desensitization; severe asthma and reactions after ingestion of NSAIDs are avoided. ENT specialists are particularly in a key position for early detection of AI.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Analgesics / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Drug Hypersensitivity / diagnosis*
  • Drug Hypersensitivity / etiology*
  • Germany
  • Humans
  • Otolaryngology / methods*
  • Otorhinolaryngologic Diseases / chemically induced*
  • Otorhinolaryngologic Diseases / diagnosis*
  • Otorhinolaryngologic Diseases / therapy

Substances

  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal