Analgesic sensitivity in children with asthma.

First described as a component of a triad seen among adults with nonallergic asthma and nasal polyps, aspirin sensitivity has subsequently been documented as a frequent concomitant of a wide range of patients with chronic asthma. Recent reports suggest that its incidence among children with asthma is higher than previously suspected. Among aspirin-sensitive asthmatics, indomethacin and newer, nonsteroid anti-inflammatory agents precipitate airway obstruction with a high frequency while phenylbutazone has a lesser effect. Reports related to acetaminophen among these patients have been inconsistent. Salicylic acid and salicylamide appear to be tolerated. A correlation between the potential for causing airway obstruction among asthmatic patients and the drug's in vitro prostaglandin synthetase activity has been suggested, and elevation of plasma histamine level at the time of the pulmonary reaction has been described. Aspirin and other analgesics may therefore mediate bronchospasm by means of their effects on prostaglandin production and the resultant effects on intracellular cyclic nucleotide activity, which modulates histamine release from mast cells in lung tissue.