[Inhalation provocation test with lysine acetylsalicylic acid (Aspisol)--a useful method for the diagnosis of analgesic asthma].

In patients with analgesics induced asthma (AIA) provocation tests by inhalation are less dangerous than oral provocation. Bianco et al. and Schmitz-Schumann et al. described an inhalation provocation test (IPT) with Lysine-acetylsalicylic-acid (Lys-ASA). We found analgesics induced asthma in 5 p.c. of our patients with bronchial asthma. The results of 41 IPT with Lys-ASA are reported. In 26 of 29 patients with analgesics intolerance in the history the test was positive after a threshold dose of 18,0 mg (9,3-53,3 mg) Lys-ASA. 3 patients believed to have analgesics intolerance. It could be excluded by negative IPT and following negative oral provocation. In a control group of 12 patients with intrinsic asthma, nasal polyps and sinusitis, but without analgesics intolerance in the history, the test was positive too in 2 patients. They didn't use analgesics in the past years. The diagnosis could be confirmed by oral provocation. In our opinion IPT with Lys-ASA is very useful to find an AIA or to exclude it. It is better controllable than oral provocation. The induced bronchospasm is good reversible by inhalation of beta-mimetics or injection of methylxanthines. Intraindividual variations of bronchial tolerance can be supposed. All patients with AIA tolerated oral provocation with salicyclamide.