Medical Journal of the Islamic Republic Of Iran

en Investigation of the Relationship between Aspirin-Sensitivity and Poor Response to Medical Management in NSAIDs-exacerbated Respiratory Disease Patients with Sinonasal Polyposis Immunology Immunology Original Research Original Research Background: NSAID-exacerbated respiratory disease (N-ERD) is a highly heterogeneous disorder with various clinical symptoms. The aspirin challenge test is a gold standard method for its diagnosis, and there are still no reliable in vitro diagnostic biomarkers yet. Oral challenge tests are time-consuming and may be associated with a risk of severe systemic reactions. This study aimed to evaluate whether patients with poor responses to medical management are more susceptible to being aspirin-sensitive.    Methods: In this cohort study, after CT scanning of all patients and subject selection, conventional medical treatment was started as follows and continued for three consecutive months: at first, saline nose wash twice per day, intranasal beclomethasone spray one puff in each nostril twice per day, montelukast 10 mg tablet once daily, a ten-day course of oral prednisolone starting with the dose of 25 mg per day and taper and discontinued thereafter. Sinonasal outcome test 22 (SNOT22) was used for the evaluation of symptom severity. Statistical analyses were performed with SPSS version 23, and data were analyzed using an independent samples T-test, paired T-test, and Receiver operating curve analysis    Results: 25 males and 53 females were enrolled in this study, with an average age of 41.56 ± 11.74 years old (18-36). Aspirin challenge test results were positive in 29 (37.2%) patients. The average SNOT22 scores before the treatment were 52.97 ± 17.73 and 47.04 ± 18.30 in aspirin-sensitive and aspirin-tolerant patients, respectively, and decreased to 27.41 ± 16.61 and 24.88 ± 16.72 in aspirin-sensitive and aspirin-tolerant patients after the treatment, respectively. There was no significant difference in SNOT22 scores between the groups.    Conclusion: The severity of symptoms before treatment and clinical improvement after treatment are not good predictors of N-ERD.   N-ERD, Aspirin-sensitive, Aspirin-tolerant, Chronic rhinosinusitis, Nasal polyposis, Asthma, SNOT22 522 528 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-7404-1&slc_lang=en&sid=1 Mohammad Nabavi Mnabavi44@yahoo.com 200319475328460077809 200319475328460077809 No Allergy and Clinical Immunology Department, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Saba Arshi sabaarshi@yahoo.com 200319475328460077810 200319475328460077810 No Allergy and Clinical Immunology Department, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Mohammad Hasan Bemanian Mhbemanian@yahoo.com 200319475328460077811 200319475328460077811 No Allergy and Clinical Immunology Department, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Morteza Fallahpour Fallahpour.morteza@gmail.com 200319475328460077812 200319475328460077812 No Allergy and Clinical Immunology Department, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Rasoul Molatefi rmolatefi@yahoo.com 200319475328460077813 200319475328460077813 No Allergy and Clinical Immunology Department, Bo-Ali hospital, Ardabil University of Medical Sciences, Ardabil, Iran Mahsa Rekabi Mahsarekabi1@yahoo.com 200319475328460077814 200319475328460077814 No Allergy and Clinical Immunology Department, Masih-Daneshvari hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Narges Eslami drnarges@yahoo.com 200319475328460077815 200319475328460077815 No Allergy and Clinical Immunology Department, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Javad Ahmadian Jahmadian76@yahoo.com 200319475328460077816 200319475328460077816 No Allergy and Clinical Immunology Department, Tabriz University of Medical Sciences, Tabriz, Iran Kian Darabi dkianedarabi@yahoo.com 200319475328460077817 200319475328460077817 No Allergy and Clinical Immunology Department, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Gholamreza Sedighi Sedigh_1352@yahoo.com 200319475328460077818 200319475328460077818 No Allergy and Clinical Immunology Department, Kerman University of Medical Sciences, Kerman, Iran Zeinab Moinfar z-moinfar@tums.ac.ir 200319475328460077819 200319475328460077819 No Community and Preventive Medicine, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Faraji ftm.faraji@gmail.com 200319475328460077820 200319475328460077820 No Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran Majid Khoshmirsafa Mj.khoshmirsafa@hotmail.com 200319475328460077821 200319475328460077821 No Department of Immunology, Iran University of Medical Sciences, Tehran, Iran Sima Shokri Shokri.s@iums.ac.ir 200319475328460077822 200319475328460077822 Yes Allergy and Clinical Immunology Department, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran