Analgesic intolerance syndrome

The analgesic intolerance syndrome, also known as Samter's triad, can trigger a variety of symptoms, such as recurring nasal polyps. An effective therapy is all the more important.

Analgesic intolerance syndrome is a symptom complex of three features:

  • Sensitivity to acetylsalicylic acid (ASA) or other non-steroidal analgetics
  • Chronic rhinosinusitis with recurrent nasal polyps
  • Non-allergic bronchial asthma

The condition is known by many names such as analgesic asthma syndrome or Samter's triad. Although it is rare, certain groups of patients such as asthmatics and people with nasal polyps, chronic sinusitis or chronic hives (urticaria) are at increased risk.

Samter's triad: Symptoms

Characteristic symptoms caused by taking ASA are:

  • Inflammation of the eyes (conjunctivitis, swelling of the eyelids and conjunctiva, lacrimation).
  • Inflammation of the nasal mucosa (nasal obstruction, runny nose)
  • Inflammation of the bronchial tubes (shortness of breath, increased secretion) up to an asthma attack.
  • Skin reaction (skin wheals, redness, rash, swelling).
  • Shock with unconsciousness and cardiovascular arrest

Intolerance reactions to acetylsalicylic acid can range from mild to severe and occur within minutes to hours after taking ASA or other non-steroidal analgesics. Many affected people also react to the consumption of foods containing salicylate, such as various spices (curry), drinks (port wine), fruit (pineapple), vegetables (peppers) or nuts.

Samter's triad: Diagnosis and Treatment

It is often difficult for patients to combine the complaints into one clinical picture. A thorough anamnesis is therefore important to determine the disease. The basis for this is a detailed patient interview. Laboratory tests provide further clues. The final diagnosis is made on the basis of an oral provocation test.

Depending on the symptoms and the results of the anamnesis and clinical examinations, we offer an effective and long-lasting therapy concept. This includes:

  • Endoscopic paranasal sinus surgery (pansinus surgery, FESS)
  • Oral provocation to confirm the diagnosis
  • ASA deactivation as causal treatment

Once an analgesic intolerance has been diagnosed with certainty, the drugs in question should be avoided as far as possible.

Individual care usually makes it possible to find an optimally tailored solution for our patients. To achieve this, we work hand in hand as a team of specialists from ear, nose and throat medicine, dermatology and pneumology. Each department takes on an important function in the therapy and has many years of experience in diagnostic and treatment of the clinical picture.

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