Samter triad

As Samter's triad (including Crohn Samter or Crohn Widal called) is called an adverse reaction after ingestion of acetylsalicylic acid (ASA) and other nonsteroidal antiinflammatory drugs (NSAIDs).

In 1922, Widal and colleagues observed that ASA intolerance very often occurs together with nasal polyps and bronchial asthma . They called this syndrome the aspirin trias . The Samter triad (sinusitis, nasal polyps, bronchial asthma) is not limited to ASA. The symptoms also occur when taking other nonsteroidal anti-inflammatory drugs, which is why the term analgesic tolerance is also used.

Patients with Samter's triad have a significantly increased tendency to recur with standard sinusitis therapy.

In asthmatics , the proportion of patients with ASA intolerance is around 8 to 20%, in patients with nasal polyps around 6 to 15%. A genetic (hereditary) predisposition is suspected.

Diagnosis

The diagnosis of intolerance reactions to ASA or analgesics is difficult to make based on anamnesis, as there is often an infection at the same time. References to a Samter triad result from:

• Asthma attacks after taking pain relievers
• Chronic nasal constriction / polyposis / pan-sinusitis

Skin tests are unsuitable for diagnosis. The benefits of laboratory tests cannot yet be conclusively assessed either. Nasal provocation tests under hospital conditions are sometimes used. Oral or bronchial provocation with ASA can be considered as a test at centers.

therapy

Adaptive deactivation is available as a newer, supportive therapy . For this purpose, after being stopped by the doctor, acetylsalicylic acid is permanently taken and can thus successfully counteract the formation of new polyps .

Individual evidence

1. ↑ Ludger Klimek u. a .: ASA intolerance (M. Samter): Clinic, diagnostics, therapy. ( Memento of the original from December 9, 2006 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. In: 5th annual conference of the German Academy for Otorhinolaryngology, Head and Neck Surgery. May 27, 2006. 
2. ↑ A. May et al .: Family examination in patients with ASA intolerance and rhinosinusitis. In: ENT. 48, 2000, pp. 650-654.
3. ^ BA Stuck: Guideline "Rhinosinusitis" of the German Society for ENT. In: ENT. 55, 2007, pp. 258-276.
4. ↑ E. Nizankowska-Mogilnicka: Guideline: aspirin provocation tests for diagnosis of aspirin hypersensitivity. In: Allergy. 62, Oct 2007, pp. 1111-1118.
5. ↑ O. Pfaar et al.: Adaptive deactivation in ASA intolerance - safety aspects of a new therapy principle with intravenous application. University of Düsseldorf.

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !