Kanazawa University School of Medicine
Correspondence to: Masaki Fujimura, MD, FCCP, The Third Department of Internal Medicine, Kanazawa University, School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan
To the Editor:
Aspirin-induced asthma is exacerbated by some kinds of
food and drug additives that are frequently included in the drugs used
for the treatment of asthma, such as injected glucocorticosteroids.
Recently, we experienced a case of aspirin-induced asthma case with
symptoms exacerbated by tacholiquine inhalation. A 69-year-old
man visited our hospital for the treatment of asthma. He had
experienced a severe asthma attack after an intake of diclofenac
sodium. Aspirin-induced asthma was diagnosed using a sulpyrine
inhalation test. The patient had been inhaling a mixed solution of
salbutamol, tyloxapol, and tacholiquine regularly. One day in October
1997, when he inhaled a solution of tyloxapol and tacholiquine, coughs
and wheeze occurred 30 min after the inhalation. Inhalation provocation
with tacholiquine was performed after informed consent was obtained. An
inhalation of 25% tacholiquine provoked a 20% decrease in
FEV1 from the post saline solution inhalation value 30 min
later (Fig 1).
Tacholiquine inhalation did not cause bronchoconstriction in six other
patients with moderate-to-severe asthma without aspirin sensitivity.
Tacholiquine contains paraben as an additive, which might cause
bronchoconstriction in this case.
Paraben has been used since the 1930s as a bacteriostatic agent added
in many drugs, foods, and cosmetics.1It is well
recognized that some patients with aspirin-induced asthma have
hypersensitivity to paraben.2
Aerosolized tacholiquine is often used as a mucolytic agent for the
treatment of chronic lung diseases, including asthma. Careful use is
necessary in treating asthmatic patients because nearly 10% of
patients with asthma have aspirin-induced asthma.
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