[Persistence of nonspecific bronchial hyperreactivity in children with non-IgE dependent bronchial asthma: pharmacologic study with the Carbachol test]. / Persistencia de la hiperreactividad bronquial inespecífica en niños con asma bronquial no IgE dependientes: estudio farmacológico mediante test de carbacol.

The authors revise their preliminary experiment with the bronchial provocation test using carbachol in 50 children of 5 to 14 years with non-IgE dependent bronchial asthma who had been asymptomatic for one year prior to the test in order to make a clinical evaluation of asthma. The observe the evolution of the non-specific bronchial hyperreactivity (NSBH) with respect to the clinical remission and determine whether the persistence of NSBH is correlated to certain clinical, epidemiological and analytical parameters (peripheral eosinophilia, total IgE). In 22 children (44%) the functional respiratory examination was normal throughout each phase of the test. In the other 56%, the functional respiratory study using carbachol showed exhalation reductions which suggested NSBH. The most significant parameters were the reductions in FEV1, PEF (p less than 0.001) and FMEF (p = 0.001). Thus the patients revealing NSBH in the carbachol test are characterised for having revealed acute asthma of higher intensity, more often associated with an acute respiratory infection and with lower values of total IgE (p less than 0.05) with respect to the group without NSBH in the carbachol test.

Adverse reaction of acetaminophen as an alternative analgesic in A.A.S. Triad.

The syndrome of A.A.S. Triad consisting of an intolerance to analgesics such as aspirin, bronchial asthma and nasal polyps, is every day more frequent. During the last years, the use of acetaminophen as an analgesic-antipyretic alternative in patients with A.A.S. Triad has been imperative. However, there are already publications that show reversible bronchial obstruction symptoms similar to the ones produced by A.A.S., though of less intensity. A study was performed in 32 patients diagnosed of A.A.S. Triad by our allergy specialized office with a challenge test of acetaminophen and placebo. Basal spiromentry, physical examination and control of medication before the test, were noted. Of the 32 patients studied, six of them showed a positive provocation test. We maintain the need to perform a provocation test with acetaminophen at the hospital under medical observation before the medication is used by the patient. In terms of practical medicine, this study with acetaminophen as medications of common use in A.A.S. Triad underlies the importance of more caution in prescribing analgesic drugs to patients sensitive to aspirin and A.I.N.E.