Clinical features of sulfite-sensitive asthmatics.

Cho, Young Soo; Baik, Su Hum; Park, Hae Sim; Rhu, Nam Soo; Cho, Dong Ill; Kim, Jae Won

doi:1992.39.2.159

Tuberc Respir Dis > Volume 39(2); 1992 > Article

Original Article

Tuberculosis and Respiratory Diseases 1992;39(2):159-166.
DOI: https://doi.org/10.4046/trd.1992.39.2.159 Published online April 1, 1992.

Clinical features of sulfite-sensitive asthmatics.

Young Soo Cho, Su Hum Baik, Hae Sim Park, Nam Soo Rhu, Dong Ill Cho, Jae Won Kim

Department of Chest Medicine, National Medical Center, Seoul, Korea

Abstract

Background
Sulfiting agents are widel y used as preservatives and antioxidants in foods, beverages and drugs including bronchodilators. There have been reports of sulfite-related reactions such as anaphylaxis, urticaria , angioedema, abdominal discomfortness as well as bronchospasm. Several investigators reported that sulfite-sensitive asthmatic patients comprised from 3.9% to 8.2% of all asthmatic patients and its prevalence was higher in steroid-dependent group than in steroid-independent group. Subjects and
Methods
We performed oral provocation test with sodium bisulfite and aspirin in 17 asthmatic patients who have experienced aggravation of their symptoms after administration of drugs or foods. All of them were steroid-dependent asthmatics. We observed clinical symptoms and steroid requirements from 1 to 18 months.
Results
Ten of them showed severe bronchoconstriction after the ingestion of sodium bisulfite (50 to 200 mg) within 30 minutes. Concurrent aspirin intolerance was noted by oral provocation test in four cases (40%). Three of them showed positive responses on skin prick test with sulfite (1 0 or 100 mg/ ml). Mean total eosinophil counts was 844/ mm 3 at asthmatic attack. And there was no significa nt responses on skin prick test and IgE.RAST to common inhalant allergens. After complete avoidance from sulfite conta ining foods and drugs as well as antiasthmatic medication for 1 to 18 months, nine of them (90%) could stop or reduce the steroid requirements .
Conclusion
It was suggested that severe steroid dependent and intrinsic type of asthmatic patients should be eva luated for sulfite .sensitivity

Key Words: Sulfite-sensitivity, Bronchial asthma

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