Salicylate Food Intolerance and Aspirin Hypersensitivity in Nasal Polyposis

Document Type: Original Article

Authors

1 Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

2 Department of Internal Medicine, Division of Rheumatology,Shiraz University of Medical Sciences, Shiraz, Iran

3 Otolaryngology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

4 Department of Allergy and Immunology, Rasool-e-Akram Hospital,Tehran, Iran

5 6ENT–Head and Neck Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran

Abstract

Background: A clear association between allergy and nasal polyposis (NP) is not
determined and the role of food intolerance in patients with NP is not investigated by
oral food challenge (OFC). Objective: To investigate the relation of salicylate food
intolerance and atopy in patients with NP according to recurrence and aspirin
sensitivity. Methods: A cross sectional multicenter study was done in two tertiary
centers for allergy in Iran. Adult patients with NP were selected for the study that had
been referred to allergy clinics. The oral aspirin challenge (OAC) test was performed to
identify aspirin exacerbated respiratory disease (AERD) and the OFC test was used to
investigate food intolerance. Atopic evaluation was performed by skin-prick tests, nasal
smear and blood eosinophil count as well as serum total IgE. Results: One hundred and
nineteen Iranian patients (female to male ratio 1.05) with NP were enrolled (mean age,
38 ± 11 years). Recurrence of nasal polyposis was 64.7%. OAC was performed in all
cases; 43.79% cases had aspirin hypersensitivity. In addition, OFC tests determined that
69.9% of patients had salicylate food allergy. Salicylate food intolerance was
significantly higher in NP cases with AERD than in aspirin tolerant patients (p<0.05).
Yet, positive skin prick test was not associated with NP recurrence and AERD.
Conclusion: Atopy and NSAID exacerbated respiratory disease; therefore, they can
both be considered as predictors of NP recurrence. Our study also showed that salicylate
food intolerance was associated with AERD in nasal polyposis.

Keywords