The Primary Causes, Symptoms and Treatment for Samter’s Triad
Samter’s Triad is a rare disease that usually develops during adulthood. The condition is treatable with the help of an aspirin allergy treatment involving desensitization. However, Samter’s Triad diagnosis and treatment requires the assistance of an allergy doctor with expertise in the field. At Chacko Allergy, Asthma and Sinus Center, we work with patients in the Atlanta area to identify common symptoms and deliver effective treatment plans for this uncomfortable condition.
According to data from The Samter’s Society, as many as 20% of patients with Samter’s Triad go undiagnosed. Sadly, a lack of treatment can lead to recurrent symptoms and ongoing ill health. But with the help of Chacko Allergy, Asthma and Sinus Center, our allergists provide patients with the comprehensive treatment they need to tackle the issue.
What Is Samter’s Triad?
Samter’s Triad is a chronic condition that is found in patients that have asthma. Samter’s Triad is also known as Aspirin Exacerbated Respiratory Disease (AERD) or ASA Triad. Some of the symptoms include sinus inflammation with recurring nasal polyps, as well as a sensitivity to aspirin.
Patients with Samter’s Triad that have taken Aspirin or related anti-inflammatory drugs, may have a reaction that could affect both the upper and lower respiratory systems. Other symptoms could include a rash as well as abdominal pain.
What are the Symptoms of Samter’s Triad?
When a patient diagnosed with Samter’s Triad takes NSAID medication like aspirin, they may develop symptoms affecting both the upper and lower respiratory systems.
Samter’s Triad is usually diagnosed by an allergist in patients that have asthma, sinus inflammation or congestion, and usually have recurring nasal polyps. Some patients have to avoid all NSAIDs like Aspirin, if they have both nasal polyps and asthma, even if they have never experienced any of the symptoms when taking Aspirin.
The symptoms in a patient with Samter’s Triad can occur 30 to 120 minutes after taking Aspirin or Aspirin related drugs. Some of the symptoms they could show include the following:
- coughing
- wheezing
- tightness in the chest
- nasal congestion
- headache
- sinus pain
- sneezing
Other possible symptoms include:
- rash
- flushing of the skin
- abdominal pain
- diarrhea or vomiting
Some patients with Samter’s Triad can lose their sense of smell due to recurring sinus infections. Patients are advised to avoid red wine and all alcoholic beverages, as 70% of patients can have a sensitivity to alcohol.
What Causes Samter’s Triad?
There is no research that shows what causes Samter’s Triad. But, according to the American Academy of Allergy Asthma and Immunology around 9% of adults with asthma and 30% of adults that have both asthma and nasal polyps show signs of Samter’s Triad.
Adults that are between the ages of 20 and 50 can develop or be diagnosed with Samter’s Triad. The average age of patients that show symptoms is 34 years old.
How Is Samter’s Triad Diagnosed?
There is no test that can diagnose a patient with Samter’s Triad. The only way to diagnose someone with this disease is by knowing that the patient is someone with the following conditions; Asthma, Nasal Polyps and a sensitivity to Aspirin.
To confirm that the patient has a sensitivity to Aspirin, your allergy doctor may do an “Aspirin Challenge Test”, which can confirm that the patient has the three conditions. This test will be performed in the hospital under the supervision of your allergist and nurses. The Aspirin test is done by giving the patient a dose of Aspirin to see if there is a reaction. When an allergy doctor suspects that a patient may have Samter’s Triad, this test is used as a diagnostic tool to see if the patient has a sensitivity to Aspirin.
Patients with Samter’s Triad sometimes have a large number of eosinophils in their nasal polyps or blood. Eosinophils are a type of immune cell.
How Is Samter’s Triad Treated?
Patients that have been diagnosed with Samter’s Triad need to treat each condition with different medications. For asthma, an inhaler or sinus rinses can be used to control respiratory symptoms and sinus inflammation. A steroid injection can be used to treat nasal polyps.
Depending on the patient and the severity of the conditions, surgery to remove nasal polyps can help Samter’s Triad even further. However, this will not cure the condition because the polyps may reappear.
There are other options that can help treat Samter’s Triad that include the following:
Aspirin Desensitization
This treatment involves creating a tolerance to aspirin. The allergy doctor performs this treatment by giving the patient doses of aspirin, slowly until the patient can tolerate the recommended dose for this treatment. After this treatment–usually lasting just one day unless severe reactions occur, in which case hospitalization may be needed until the recommended dose is tolerated–the patient will continue taking the prescribed daily dose of aspirin.
Aspirin Desensitization is especially important if the patient needs to take Aspirin or any other NSAID medication for cardiovascular disease or chronic pain.
After completing Aspirin Desensitization treatment, it can improve the patient’s asthma and sinus inflammation, which then can decrease the chances of nasal polyps.
Avoidance of Aspirin and Other NSAID Medications
Patients that can’t undergo Aspirin Desensitization should avoid all NSAIDs. It is hard for any patient to avoid all NSAIDs due to these medications being used to treat or manage other conditions, like cardiovascular diseases or other conditions.
Patients who were unable to proceed in aspirin desensitization treatments, will continue to have the symptoms of asthma, nasal inflammation, and recurring polyps. These patients may still need to have repeated sinus surgeries due to nasal polyps and continue with their medications to manage symptoms.
Other Interventions
There is one other method that your allergy doctor could try, and that is giving the patients a drug called a leukotriene-modifying agent. This drug can be used to reduce inflammation in the patient’s airways.
Other studies show that these drugs can also improve a patient’s lung functions, asthma flare-ups, and reduce eosinophils that are found in nasal polyps.
Some foods can contain an ingredient called Salicylic Acid. If a patient avoids these foods, it can also help their conditions. Salicylic Acid is an ingredient that is used in Aspirin. Some types of foods that could have Salicylic Acid include certain fruits, vegetables, herbs, and spices. Ask your allergist which foods you should avoid to help manage your symptoms.
Common Questions About Samter’s Triad
How common is Samter’s Triad?
For those who have asthma, Samter’s Triad is relatively common. Among people with severe allergies, up to 15% may suffer from the disease. For those without asthma, Samter’s Triad is far less common.
Can Samter’s Triad develop later in life?
Samter’s Triad typically develops later in life, affecting adults far more often than it does children – in fact, it’s rare for children to develop Samter’s Triad. The onset of the condition is most often seen in people in their 30s or 40s.
Is Samter’s Triad treatment safe?
Treatment for Samter’s Triad is considered safe when administered by trained medical professionals. Each treatment option will carry different levels of risk, but any potential issue can be addressed and managed quickly.
Contact Your Local Samter’s Triad Specialist
Chacko Allergy, Asthma and Sinus Center specializes in asthma conditions and can help diagnose if a patient has Samter’s Triad. We can help control a patient’s conditions and symptoms. Call our office at (678) 668-4688 or schedule an appointment today.
