Journal
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
Volume 4, Issue 4, Pages 665-670Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jaip.2016.03.004
Keywords
Urinary; Leukotriene; LTE4; Aspirin; Sensitivity; AERD; Rhinosinusitis; Diagnostic; Specificity; Predictive
Categories
Funding
- Mayo Clinic Foundation
Ask authors/readers for more resources
BACKGROUND: Urinary leukotriene E4 (LTE4) is a well-validated marker of the cysteinyl leukotriene pathway, and LTE4 elevation has been described in conditions such as asthma, aspirin sensitivity, and chronic rhinosinusitis (CRS). There have been a number of reports investigating the role of spot urine LTE4 to predict aspirin sensitivity; however, variability in urinary LTE4 may affect the accuracy of this approach. OBJECTIVE: Here, we explored the utility of 24-hour urinary LTE4 in 5 clinical diagnoses of allergic rhinitis, asthma, chronic rhinosinusitis with nasal polyps (CRSwNP), CRS without nasal polyps, and aspirin sensitivity. METHODS: This was a retrospective review of patients who had 24-hour quantification of urinary LTE4 by a clinically validated liquid chromatography tandem mass spectrometry method and their assigned diagnoses after assessment and clinical care. RESULTS: Twenty-four-hour urinary LTE4 elevations were seen in those with asthma and those with CRSwNP but influenced by underlying aspirin sensitivity. Elevation in LTE4 was significant in those with CRSwNP after adjusting for aspirin sensitivity. Allergic rhinitis was not associated with elevated LTE4 excretion. Receiver operator characteristic analysis of 24-hour urinary LTE4 showed that a cutoff value of 166 pg/mg Cr suggested the presence of history of aspirin sensitivity with 89% specificity, whereas a cutoff value of 241 pg/mg Cr discriminated challenge-confirmed aspirin-sensitive subjects with 92% specificity. CONCLUSIONS: Elevated 24-hour excretion of urinary LTE4 is a reliable and simple test to identify aspirin sensitivity in patients with respiratory diagnoses. (C) 2016 American Academy of Allergy, Asthma & Immunology
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available