Aspirin-exacerbated respiratory disease

Aspirin-exacerbated respiratory disease, abbreviated AERD, is also called NSAID-exacerbated respiratory disease and has historically been known as aspirin-induced asthma and Samter's triad. It is a long-term disease defined by three simultaneous features: asthma, chronic rhinosinusitis with nasal polyps, and intolerance of aspirin and other nonsteroidal anti-inflammatory drugs. Asthma and nasal polyps tend to be more severe than in aspirin-tolerant patients, and loss or reduction of smell is extremely common, occurring in more than 90 percent of people with the disease. It usually begins in early to mid adulthood and has no known cure. The underlying cause is a dysregulation of the arachidonic acid pathway and of several innate immune cells, though the trigger for that dysregulation is unknown. Treatment manages symptoms with corticosteroids, surgery, diet changes, monoclonal antibody drugs and, paradoxically, daily aspirin after desensitization.