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| Salicylate sensitivity Classification and external resources |
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| Salicylic acid | |
| ICD-9 | 965.1 |
Salicylate sensitivity, also known as salicylate intolerance, is any adverse effect that occurs when a normal amount of salicylate (salicylic acid) is introduced into a person's body. People with salicylate intolerance are unable to consume a normal amount of salicylate without adverse effects.
Salicylates are derivatives of salicylic acid that occur naturally in plants and serve as a natural immune hormone and preservative, protecting the plants against diseases, insects, fungi, and harmful bacteria. Salicylates can also be found in many medications, perfumes and preservatives. Both natural and synthetic salicylates can cause health problems in anyone when consumed in large doses. But for those who are salicylate intolerant, even small doses of salicylate can cause adverse reactions.
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Terminology
Depending on whether the salicylate is a component of food or medicine, salicylate intolerance is a form of food intolerance or of drug intolerance.
Salicylate sensitivity is a pharmacological reaction, not an allergy.citation needed However, it is possible for aspirin to trigger hypersensitivity reactions.1 About 5-10% of asthmatics have aspirin hypersensitivity.2
A closely related concept is "salicylism", which refers to an overdose of salicylates,3 without addressing individual susceptibility.
Samter's triad refers to aspirin sensitivity in conjunction with nasal polyps and asthma.4
History
An important salicylate drug is aspirin, which has a long history. Aspirin intolerance was widely known by 1975, when the understanding began to emerge that it is a pharmacological reaction, not an allergy.56
Symptoms
The most common symptoms of salicylate sensitivity are:citation needed
- Itchy skin, hives or rashes
- Stomach pain/upset stomach
- Asthma and other breathing difficulties
- Angioedema
- Headaches
- Swelling of hands, feet, eyelids, face and/or lips
- Bed wetting or urgency to pass water
- Persistent cough
- Changes in skin color/skin discoloration
- Fatigue
- Sore, itchy, puffy or burning eyes
- Sinusitis/Nasal polyps
- Diarrhea
- Nausea
- Hyperactivity
- Memory loss and poor concentration
- Depression
- Pseudo-anaphylaxis
Treatment
There is currently no scientific method that will accurately determine if a person is sensitive to salicylates or not. This is because salicylate sensitivity is a dose-related reaction and symptoms only occur when the tolerance level of the individual has been exceeded. One method currently available to determine food intolerance is an elimination diet. Completely eliminating salicylate from one’s diet and environment for 4 to 6 weeks can decrease or possibly eliminate all symptoms involved with salicylate intolerance. After this time period, most salicylate intolerant people can consume or come into contact with occasional small doses of salicylate without symptoms re-occurring. Alternately, those who are extremely sensitive to salicylates should avoid salicylates as much as possible.
Montelukast is one form of treatment used in aspirin-intolerant asthma.7
References
- ^ Palikhe NS, Kim SH, Park HS (October 2008). "What do we know about the genetics of aspirin intolerance?". Journal of clinical pharmacy and therapeutics 33 (5): 465–72. doi:. PMID 18834360. http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0269-4727&date=2008&volume=33&issue=5&spage=465.
- ^ Jang AS, Park JS, Park SW, et al (November 2008). "Obesity in aspirin-tolerant and aspirin-intolerant asthmatics". Respirology (Carlton, Vic.) 13 (7): 1034–8. doi:. PMID 18699807. http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=1323-7799&date=2008&volume=13&issue=7&spage=1034.
- ^ salicylism at Dorland's Medical Dictionary
- ^ Kim JE, Kountakis SE (July 2007). "The prevalence of Samter's triad in patients undergoing functional endoscopic sinus surgery". Ear, nose, & throat journal 86 (7): 396–9. PMID 17702319.
- ^ Casterline CL (November 1975). "Intolerance to aspirin". Am Fam Physician 12 (5): 119–22. PMID 1199905.
- ^ Patriarca G, Venuti A, Schiavino D, Fais G (1976). "Intolerance to aspirin: clinical and immunological studies". Z Immunitatsforsch Immunobiol 151 (4): 295–304. PMID 936715.
- ^ Kim SH, Ye YM, Hur GY, et al (September 2007). "CysLTR1 promoter polymorphism and requirement for leukotriene receptor antagonist in aspirin-intolerant asthma patients". Pharmacogenomics 8 (9): 1143–50. doi:. PMID 17924829. http://www.futuremedicine.com/doi/abs/10.2217/14622416.8.9.1143?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dncbi.nlm.nih.gov.
External links
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