I have been told that I have a condition referred to as Francis Triad (nasal polyps, asthma and an allergic reaction to aspirin). How common is this and what is the preferred treatment?

W.

The correct name for this condition is Samter's triad or Samter's syndrome. In a full-time practice, I see perhaps two or three patients each year with this problem, so in my opinion it falls into the category of "not common, but not rare." The cause of Samter's syndrome is unknown. Like allergies, Samter's syndrome may be acquired at any time in one's life. In some individuals there appears to be a genetic component.
The three aspects of the triad are treated separately. Avoiding aspirin and aspirin-containing medications is essential. Treatment of your asthma will depend on the severity of the problem: Some people require medication only when they are having an attack, while others need to be on medications on a daily basis. In general, asthma patients learn what environmental factors trigger an asthma attack, and they know to avoid them.

Nasal polyps can cause sinusitis, postnasal drainage and nasal-airway obstruction. If your polyps are not causing any of these problems, you do not need any specific treatment. Otherwise, a surgeon can remove the polyps, or you can take medications (corticosteroids) that shrink them.

Finally, about 10 percent of people with Samter's syndrome are also afflicted with urticaria (hives) or angioedema (periodic swelling of the lips, tongue and neck). Attacks of hives or angioedema are treated with antihistamines and, if necessary, corticosteroid medicines. Angioedema can be so severe as to cause death by suffocation, so it is considered a medical emergency.