Are chronic urticaria, analgesic intolerance and seasonal rhinitis markers of different severities and phenotypes of the asthma they accompany?

Background: Asthma is a heterogeneous disease that presents with different clinical phenotypes. We aimed to compare the patients with asthma diagnosis alone with the patients, who, in addition to their asthma had accompanying analgesic intolerance (AI), chronic urticaria (CU) or seasonal rhinitis (SR) if there are any distinctions and specific characteristics of these defined patient groups. Methods: Eighty-four asthma patients diagnosed with SR, 46 with CU, 75 with AI and 71 patients with asthma alone were enrolled to the study retrospectively. The reference group for the comparisons was the group with astma diagnosis alone. Results: The mean age of all patients was 37.2±13 (15–80) and 70.7% of them were females. Asthma patients with SR had a significantly earlier onset of asthma (age: 27.4±10.8 and 34.5±15.9; respectively, p<0.01), significantly better pulmonary function tests and were significantly more atopic (92.9% and 28.8%; p<0.001). Moderate-to-severe asthma significantly correlated with older age at the time of diagnosis, older age of asthma onset, higher body mass index, less atopy and fewer pollen sensitivity. Asthma severity of patients with SR was significantly milder than the reference group (OR: 0.6, 95% CI 0.5–0.8). Asthma with AI tended to be more severe although the relation was insignificant (OR:1.6 95% CI:0.8–3.5). Conclusions: Asthma patients with SR have significantly milder and earlier onset of asthma, better pulmonary function tests and are significantly more atopic while asthma with AI tends to be more severe. Asthma with CU does not show a specific phenotypic characteristic

Asthma and allergy in Turkish university students: Two cross-sectional surveys 5 years apart

Background: prevalence of asthma and allergic diseases is increasing worldwide. We investigated the first-year university students to a) determine prevalence of asthma, and allergic diseases, b) compare prevalence with a similar study conducted in 1994, and c) investigate determinants of asthma, current wheeze and seasonal rhinitis. Methods: an ECRHS based questionnaire was distributed to 5,406 students and completed by 4,639 (response: 85.3 %) in september 1999. Information from the students residing in Turkey was used in the analyses (1,800 boys, 2,712 girls). Results: prevalence % of asthma (symptom and/or medicine), current wheeze and seasonal rhinitis were 2.1, 6.9 and 12.7 in boys, and 2.5, 7.2 and 14.5 in girls. Current smoking, pet ownership and family atopy was reported more frecuently in 1999 than 1994. Cough and seasonal rhinitis increased almost twofold. Asthma diagnosis and attack rate was similar in 1999 and 1994. Family atopy, pet in childhood, smoking and passive smoking in childhood increased the risk of asthma, and current wheeze. Family atopy, passive smoking and current pet ownership increased the risk of seasonal rhinitis. Conclusion: increased rate of smoking and pet ownership could contribute to the increased prevalence of asthma and allergic diseases in the last 5 years (AU)

Antecedentes: la prevalencia de asma y enfermedades alérgicas está aumentando en todo el mundo. Investigamos a estudiantes universitarios de primer año para a) determinar la prevalencia de asma, y de enfermedades alérgicas; b) comparar la prevalencia con un estudio similar llevado a cabo en 1994, y c) investigar los determinantes de asma, sibilancias actuales y rinitis estacional. Métodos: se distribuyó un cuestionario basado en el ECRHS a 5.406 estudiantes, completándolo 4.639 estudiantes (tasa de respuesta del 85,3 por ciento) en septiembre de 1999. En los análisis se utilizó la información procedente de los estudiantes que residían en Turquía (1.800 varones y 2.712 mujeres).Resultados: la prevalencia porcentual de asma (síntomas y/o utilización de fármacos), sibilancias actuales y rinitis estacional fue de 2,1, 6,9 y 12,7 en varones y de 2,5, 7,2 y 14,5 en mujeres. En 1999, se documentó más frecuentemente que en 1994 hábito tabáquico actual, la presencia de un animal doméstico y atopia familiar. La tos y la rinitis estacional aumentaron casi el doble. El diagnóstico de asma y la tasa de crisis de asma fueron similares en 1999 y 1994. La atopia familiar, la presencia de un animal doméstico en la infancia, el hábito tabáquico y el tabaquismo pasivo en la infancia aumentaron el riesgo de asma y de sibilancias actuales. La atopia familiar, el tabaquismo pasivo y la presencia actual de un animal doméstico aumentaron el riesgo de rinitis estacional. Conclusión: el aumento de la tasa de hábito tabáquico y la presencia de un animal doméstico podrían contribuir a la mayor prevalencia de asma y enfermedades alérgicas en los últimos 5 años (AU)

From analgesic intolerance to analgesic induced asthma: are there some determinants?

Background: analgesic intolerance (AI) sometimes appear alone and sometimes with bronchial asthma affecting about 10% of asthmatics and sometimes before and the other times after asthma. Objective: we investigated the possible clinical risk factors which might be affecting the transition from isolated AI to analgesic induced asthma (AIA). Methods: a total of 344 patients admitted to Hacettepe University Hospital Adult Allergy Unit between January 1991 and March 1999 and diagnosed with AI were enrolled in this survey. Patients having AIA (group I) (n = 191) were compared with the patients having AI without asthma (group II) (n = 153). The diagnosis of AI and AIA were made by history and oral provocation tests. A standard questionnaire was filled-in for all the patients. Results: the risk of AIA was increased with nasal polyp, and rhinosinusitis via OR’s of 2.75 (95% CI: 1.09, 6.91), and 18.58 (95% CI: 9.86, 35.01), respectively. Having a pet, and ever smoking decreased the risk of AIA in the patients with AI via OR’s of 0.53 (95% CI: 0.24, 1.17), and 0.37 (95% CI: 0.17, 0.80), respectively. The association of AIA and smoking was slightly modified by food intolerance (OR for ever smoked and food intolerance: 1.31, 95% CI: 0.40, 4.30). Conclusion: there may be two different phenotypes of AI with different clinical features: one developing AIA (having nasal polyp and/or rhinosinusitis, and smoking if food allergy/ intolerance is present), and the other AI without asthma (having pet, and could smoke). Findings of this study should be confirmed by further investigations (AU)

Antecedentes: la intolerancia a analgésicos (IA) puede aparecer aislada o con asma bronquial. Afecta aproximadamente el 10 por ciento de las personas asmáticas y puede aparecer antes o después de un episodio de asma.Objetivo: investigamos los posibles factores de riesgo clínico que pueden contribuir a la evolución de IA aislada a asma inducida por analgésicos (AIA).Métodos: fueron incluidos en esta encuesta 344 pacientes ingresados en la Unidad de Alergia de Adultos del Hospital Universitario Hacettepe entre enero de 1991 y marzo de 1999 con el diagnóstico de IA. Los pacientes con AIA (grupo I) (n = 191) se compararon con los pacientes con IA sin asma (grupo II) (n = 153). Los diagnósticos de IA y AIA se establecieron por la historia y pruebas de provocación oral. Todos los pacientes completaron un cuestionario estándar.Resultados: el riesgo de AIA aumentó en presencia de pólipo nasal y rinosinusitis, con OR de 2,75 (IC 95 por ciento: 0,24; 1,17) y 0,37 (IC 95 por ciento: 0,24; 1,17) y 0,37 (IC 95 por ciento: 0,17; 0,80), respectivamente. La asociación de AIA con tabaquismo se modificó ligeramente con la intolerancia a alimentos (OR de ser fumador e intolerancia a alimentos: 1,31, IC de 95 por ciento: 0,40; 4,30).Conclusión: posiblemente existen dos fenotipos de IA cuyas características clínicas difieren: uno que evoluciona a AIA (con pólipo nasal y/o rinosinusitis, y hábito de fumar si existe una alergia/intolerancia a alimentos) y el otro de IA sin asma (presencia de un animal doméstico, posible fumador). Los resultados de este estudio deben ser confirmados por nuevas investigaciones (AU)