Samter's triad

Collection of Medicine MCQs (Cardiovascular system) for medical students. Concept based MCQs with detailed explanations which help students to gain valuable insights and gain an edge in competitive examinations. More than just answering MCQs, the explanations will improve the knowledge and understanding about the conditions discussed. Also useful for MD students who are preparing for Superspeciality entrance examinations. Medicine MCQs - Cardiovascular System Kindle Edition: Click Here for a Preview. Comments and suggestions are most welcome.
  • Samter’s triad is a condition characterised by:
    • Asthma
    • Nasal polyps
    • Aspirin intolerance

Clinical course

  • Starts as nasal symptoms of sneezing, running nose and congestion
  • Progresses to asthma and nasal polyposis (especially ethmoidal polyps)
  • Aspirin intolerance comes last
  • Allergic reaction to aspirin in these patients may cause
    • Exacerbation of asthma
    • Uriticaria
    • Angioedema – It is a life threatening condition and hence a medical emergency

Pathophysiology:

  • Aspirin being a cyclooxygenase inhibitor, causes increased activity of the leukotriene synthesis pathway
  • The excess production of leukotrienes cause allergic reactions like asthma

Treatment:

  • Each component of Samter’s triad is treated separately
    • Aspirin intolerance
      • Stop aspirin intake
      • Leukotriene antagonsits (montelukast, zafirlukast)
      • Aspirin desentisation therapy
      • Steroids
    • Asthma – treat according to severity
    • Nasal polyps – treat if they are symptomatic
      • Steroids – medical polypectomy
      • Surgical removal

Samter’s triad is also known as:

  • Samter’s syndrome
  • Aspirin triad
  • Asthma triad
  • Acetyl salicylic acid triad
  • Widal-Abrami-Lermoyez triad
  • Widal-Lermoyez syndrome
  • Widal’s syndrome
  • Francis’ triad

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