Do I Have AERD (Samter's Triad)?
Signs of AERD
Many people have asthma. Nasal polyps are also quite common. If you have both, there's a greater chance that you might have Aspirin Exacerbated Respiratory Disease. Research has found that about 16% of patients with nasal polyps have AERD. Among those with both asthma and nasal polyps, about 40% have AERD. The symptoms of AERD (Samter's Triad) typically develop over 1-5 years. You will not have every symptom in the beginning stages of the disease.
Signs of AERD:
Rapid regrowth of nasal polyps following surgery.
A complete loss of sense of smell.
The development of asthma as an adult, or a sudden worsening of asthma as an adult.
Sinus or asthma reactions to alcohol.
Sinus or asthma reactions to aspirin and NSAIDs.
Not every AERD (Samter's Triad) patient has all of these symptoms. Reactions to aspirin and other NSAIDs are the hallmark of AERD. If you don't have such reactions, you do not have AERD. However, many patients are not aware that they have developed a sensitivity to aspirin and other NSAIDs. Research has also shown that people who take daily aspirin and appear to tolerate it may have AERD. Not every patient has severe asthma, although many do. In some patients, asthma is very mild. In others, asthma never develops.
If you think you may have AERD (Samter's Triad), you should find a doctor who knows about the disease and how to treat it. Unfortunately, primary care doctors often have no knowledge of this condition. If your primary care doctor does know about it, he/she will most likely refer you to an allergist or ENT. Read more about how AERD is diagnosed.
Also, be aware that the first symptoms of the disease are often insidious. Many AERD (Samter's Triad) patients had a general feeling of malaise, facial pain, or feeling like they had a cold that wouldn't go away before developing any obvious signs of AERD.
If you think you may have AERD (Samter's Triad), you may wish to avoid aspirin and other NSAIDs until you've consulted a doctor.
The below chart was published in a recent review on AERD in the New England Journal of Medicine. It shows the likelihood of a patient having a positive aspirin challenge test based on their history.