Provocation test in patients with different phenotypes of aspirin hypersensitivity

Background Aspirin (ASA) hypersensitivity has a complex clinical presentation with three major phenotypes: aspirinexacerbated respiratory disease (AERD; asthma and/or nasal polyps), chronic urticaria and aspirin-induced anaphylaxis. In patients with AERD asthma is often severe and difficult to control. Moreover, NSAID ingestion may provoke life-threatening attack. Thus, diagnosing of ASA hypersensitivity is an important issue. In everyday practice ASA hypersensitivity is confirmed by oral (OPT), nasal (NPT) or bronchial provocation tests. However their protocols vary in terms of maximum cumulative dose. Besides, phenotype of hypersensitivity is not taken into consideration when choosing the protocol.