Current allergy and asthma reports
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A growing number of studies show that regular use of acetaminophen (paracetamol) carries a dose-dependent risk of developing allergies in general and asthma in particular and of worsening other respiratory diseases and lung function. The most disturbing finding has come from the population-based Avon Longitudinal Study of Parents and Children, in which use of paracetamol-but not aspirin-in late pregnancy was positively associated with asthma when comparing children whose mothers took paracetamol "sometimes" and "most days/daily" with those whose mothers never took it. ⋯ In this review, we present data from the most important studies published since 2000. Although the pathophysiology remains unclear, the available data justify a warning to the general public that the uncritical use of over-the-counter acetaminophen can lead to the development of allergies and asthma, even in utero.
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Curr Allergy Asthma Rep · Mar 2009
ReviewAspirin sensitivity and desensitization for asthma and sinusitis.
NSAIDs-including aspirin (ASA)-that inhibit cyclooxygenase (COX)-1 induce nonallergic hypersensitivity reactions consisting of attacks of rhinitis and asthma. Such reactions occur exclusively in a subset of asthmatic patients who also have underlying nasal polyps and chronic hyperplastic eosinophilic sinusitis. We now refer to their underlying inflammatory disease of the entire respiratory tract as aspirin-exacerbated respiratory disease. This review focuses on descriptions of these patients; methods available to diagnose ASA-exacerbated respiratory disease; the unique ability of all NSAIDs that inhibit COX-1 to cross-react with ASA; lack of cross-reactivity with selective COX-2 inhibitors; an update on pathogenesis; and current thoughts about treatment, including ASA desensitization and daily ingestion of ASA itself.