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Acute respiratory disease and flare-up of chronic spontaneous urticaria: case report A 39-year-old man developed acute respiratory disease and flare-up of chronic spontaneous urticaria following treatment with aspirin/citric acid/sodium bicarbonate. The man presented with an initial diagnosis of anaphylaxis triggered by aspirin/citric-acid/sodium-bicarbonate [Alka Seltzer; route, dosage and therapeutic indication not stated], 10 days after admission in the ICU. At the current presentation, he had symptoms of dyspnoea and urticaria. His medical history was significant for the similar symptoms after the administration of ketorolac [Toradol] and ibuprofen, along with chronic urticaria, nasal congestion, anosmia and poorly controlled asthma. Additionally, he had a history of hypertrophic pansinusitis and numerous eosinophils in the mucosa. During consultation at the current presentation, he had HR 95 /min. Upon anamnesis, it was revealed that during the last admission, he had tachycardia, due to which discharge was not possible. However, he was discharged against medical advice. At the current presentation, he was diagnosed with acute episode of aspirin-induced respiratory disease, chronic spontaneous urticaria, and tachycardia of undetermined aetiology. It was determined that the skin symptoms were augmented due to aspirin-triggered flare up of chronic spontaneous urticaria [duration of treatment to reactions onsets not stated]. The tachycardia was determined to be secondary to an undiagnosed Graves’ disease. The man received treatment with montelukast and unspecified inhaled corticosteroid. Additionally, he underwent aspirin provocation/desensitisation [outcomes not stated]. Author comment: "I concluded that he had aspirininduced respiratory disease (ARED)". "The patient had acute episode of ARED, with skin symptoms augmented by aspirintriggered flare up of chronic spontaneous urticaria." Kosinski S. A CASE OF ASPIRIN-INDUCED RESPIRATORY DISEASE (ARED) MISDIAGNOSED AS ANAPHYLAXIS DUE TO COEXISTING DISEASES. Annals of Allergy, Asthma and Immunology 123 (Suppl.): S140, No. 5, 1 Nov 2019. Available from: URL: https://www.annallergy.org/issues [abstract] 803431871 - USA

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Reactions 9 Nov 2019 No. 1778