Alcohol intolerance in patients with nasal polyposis and NSAID-exacerbated respiratory disease (N-ERD)

Introduction:

The association of ASS intolerance, chronic rhinosinusitis with nasal polyposis (CRSwNP) and/or asthma is referred to as NSAID-exacerbated respiratory disease (N-ERD). In the literature, rhinitis disorders after alcohol consumption in CRSwNP patients with N-ERD have been described, whereas the diagnosis of the disease was not systematically confirmed with ASS provocation. In the following study, the frequency of alcohol intolerance with rhinitis symptoms in the CRSwNP groups with/without ASS intolerance and asthma after previous ASS provocation was investigated and compared.

Methods:

Included in the prospective study were patients with the following phenotypes: CRSwNP, asthma, with ASS intolerance (AI) (CRSwNP-AAI), CRSwNP, asthma without an AI (CRSwNP-A), and an isolated CRSwNP. Nasal ASS provocations up to a maximum of 25 mg occurred in all patients. Rhinitis complaints after alcohol consumption, furthermore age, gender, Davos nasal polyposis [NP] score, Sinus-surgery [n] and rhinosinusitis-outcome-measurement-31 (RSOM-31) were also recorded. The man Whitney U Test was used (p < 0.05).

Results:

Included were 30 patients each in the CRSwNP-AAI (ø 47y, 17f/13 m) and in the CRSwNP-A group (ø 38y, 20f/10 m) and 27 patients in the CRSwNP group (ø 42y, 14f/13 m). Alcohol intolerance was reported in 76% of CRSwNP-AAI, 64% of CRSwNP-A and 43% of CRSwNP patients. The rhinological parameters and the RSOM-31 score did not differ significantly.

Conclusions:

After ASS provocations, alcohol intolerance is most often shown in CRSwNP patients with asthma and ASS intolerance. The reasons for this are still unknown, which should be investigated in follow-up studies.

Publication History

Publication Date:
23 April 2019 (online)