Aspirin
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Aspirin-exacerbated respiratory disease: case report A male patient [age at reaction onset not stated] developed aspirin-exacerbated respiratory disease (AERD) during treatment with aspirin [duration of treatment to reaction onset and outcome not stated]. The male patient, who had been receiving aspirin [route, dosage and indication not stated], developed AERD. He underwent a failed attempt of aspirin desensitisation and five sinus surgeries. At the age of 55 years, he presented with bilateral hearing loss of 8 years duration and chronic nasal congestion, with discharge that was refractory to maximal medical therapy. Physical exam showed bilateral aural polyps, bilateral subtotal tympanic membrane perforations and bilateral nasal polyps. A CT scan of the sinuses confirmed extensive prior endoscopic sinus surgery (ESS), with mucosal changes and extensive polyps with neoosteogenesis. The male patient was treated with unspecified steroids and antibiotics. Then, he underwent ESS with polypectomy, and he recovered without any complications. Sino-nasal mucosa with moderate chronic inflammation and non-necrotising granulomas were observed on surgical pathology. Also, 10–100 eosinophils per high powered field were noted. Six months after operation, he underwent aspirin desensitisation, followed by a long-term aspirin maintenance therapy. Four months following desensitisation, his ear exam showed an increase in the right tympanic membrane perforation, with inflamed mucosa and mild drainage, with progression of the left aural polyps to full obstruction of the left ear canal. He had aural drainage and infection, due to which he was unable to use conventional hearing aids for persistent bilateral moderate-to-severe mixed hearing loss. Therefore, a left bone anchored hearing aid placement with bilateral aural polyp removal was scheduled. Also, treatment with an unspecified biologic drug was planned. Schettino AE, et al. Aural polyps in aspirin-exacerbated respiratory disease. Otolaryngology Case Reports 17: Nov 2020. Available from: URL: http://doi.org/10.1016/ 803516980 j.xocr.2020.100225
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Reactions 21 Nov 2020 No. 1831
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