Temporal relationship of allergic rhinitis with asthma and other co-morbidities in a Mediterranean country: a retrospective study in a tertiary reference allergy clinic

Allergol Immunopathol (Madr). 2010 Sep-Oct;38(5):246-53. doi: 10.1016/j.aller.2009.11.007. Epub 2010 Apr 15.

Abstract

Background: Allergic rhinitis is a global health problem which causes major illness and represents a risk factor for asthma. The primary aim of the study was to record the clinical pattern of allergic rhinitis and its temporal relation with asthma in a Greek population.

Methods: Three-hundred and sixteen subjects with documented diagnosis of allergic rhinitis in a two-year period were included in this study. All participants completed a standardised questionnaire with full retrospective epidemiological data for rhinitis; in addition, serum IgE measurement and skin prick tests with 22 common inhalant allergens were carried out, while spirometry was performed in subjects with self-reported or doctor-diagnosed asthma. All subjects with at least one positive skin test were included in study analysis.

Results: One-hundred and sixty five out of 316 patients (49.1%) stated self reported-asthma while in 63/316 (19.9%) asthma was documented with spirometry. One hundred out of 165 (60.6%) had rhinitis as first clinical manifestation while in 24/165 (14.5%) asthma symptoms appeared first; the remaining 31/165 (24.9%) reported simultaneous onset of upper and lower airways' symptoms. About 68.5% were sensitised to seasonal allergens exclusively, while 50% were sensitised to ≥ 1 of Parietaria, grasses sp., Olea eur. The duration of rhinitis in the subpopulation of patients with self-reported asthma (n=165) was significantly higher compared with non-asthmatics (mean=3.22 years, p<0.001). Survival analysis for the estimation of asthma onset showed that the mean time interval with rhinitis only is 16.6 years (median 12 years, incidence 0.0596).

Conclusions: The unique environmental conditions and the aerobiology of each area clearly affect the clinical features of respiratory allergy.

MeSH terms

  • Adolescent
  • Adult
  • Allergens / immunology*
  • Asthma / diagnosis
  • Asthma / epidemiology*
  • Asthma / physiopathology
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Greece
  • Humans
  • Incidence
  • Male
  • Mediterranean Region
  • Parietaria
  • Pollen / immunology*
  • Retrospective Studies
  • Rhinitis, Allergic, Seasonal / diagnosis
  • Rhinitis, Allergic, Seasonal / epidemiology*
  • Rhinitis, Allergic, Seasonal / physiopathology
  • Skin Tests
  • Spirometry

Substances

  • Allergens