Samter’s Triad
Contents
- 1 Samter’s triad is characterized by the triad of
- 2 Disease with Samter’s Triad is also called
- 3 Diagnosis of AERD
- 4 Patients are considered candidates for an AERD diagnosis if they meet the following three points:
- 5 Further, if a patient meets two or more of the following criteria, then an AERD diagnosis is strongly considered:
- 6 High urinary leukotriene E4
- 7 Strong negative predictive value
- 8 AERD
- 9 Aspirin challenge test
Samter’s triad is characterized by the triad of
A. Bronchial asthma
B. Nasal polyps
C. Aspirin intolerance
Disease with Samter’s Triad is also called
- Aspirin-exacerbated respiratory disease (AERD)
- NSAID-exacerbated respiratory disease (NERD/N-ERD)
- Aspirin-induced asthma
- Samter’s Triad
Diagnosis of AERD
Patients are considered candidates for an AERD diagnosis if they meet the following three points:
- History of adverse reactions to aspirin or other NSAIDs
- Reduced ability to smell (hyposmia or anosmia)
- History of rhinosinusitis and nasal polyps
Further, if a patient meets two or more of the following criteria, then an AERD diagnosis is strongly considered:
- Moderate or severe asthma
- Asthma with an intractable cough
- Onset of asthma after adolescence
- A weakly atopic disposition
- 10% or greater increase in peripheral eosinophilia
High urinary leukotriene E4
High urinary leukotriene E4 (uLTE4) concentration is also a sign of AERD.
High uLTE4 concentration alone cannot be used to diagnose AERD.
Strong negative predictive value
It may be possible to rule out AERD in patients without high uLTE4 due to its strong negative predictive value.
AERD
Urinary LTE4 concentration is generally around 3 to 5 times higher in patients with AERD that it is in those with aspirin-tolerant asthma,
Aspirin challenge test
Urinary LTE4 concentration – Increases 2 to 30 fold during an aspirin challenge test