Question: A 31 year old woman is evaluated for chronic rhinosinusitis with nasal polyposis. History reveals that she has moderate asthma and develops increased respiratory symptoms with ibuprofen intake. Examination reveals complete bilateral nasal obstruction by inflammatory polyps. Apart from history and physical examination, which of the following can be used to make the diagnosis of aspirin exacerbated respiratory disease?

a) Elevated total serum IgE

b) Urine LTE4 greater than 165 pg/mg

c) Biopsy of a polyp

d) Presence of greater than 100 eosinophils per high power field in nasal secretions

[Answer will be posted with next week's new question]

Answer to last week's question, “Origins" (July 1, 2019)

D - Sympathetic trunk schwannoma.