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Rinitis alérgica e hiperreactividad bronquial

Rinitis alérgica e hiperreactividad bronquial

Valdesoiro, L; Bosque, M; Marco, MT; Asensio, O; Antón, J; Larramona, H;
Next Document Allergol Immunopathol (Madr). 2004;32:340-3.

Abstract

Background: Bronchial hyperreactivity (BHR) is a characteristic of bronchial asthma. Patients with allergic rhinitis who do not report symptoms of bronchial asthma on spirometry show BHR, which could indicate the presence of subclinical inflammation of the lower respiratory airway. The aim of this study was to investigate whether the patients diagnosed with allergic rhinitis in our unit without symptoms of bronchial asthma had bronchial hyperreactivity and to determine which allergens caused these symptoms in our patients. Methods and results: We performed a retrospective, observational study of patients diagnosed with allergic rhinitis in our Allergy Unit between August 2000 and December 2001. The patients' medical records were reviewed and data on the following were gathered: demographic information, age, sex, rhinitis symptoms (perennial or seasonal), conjunctivitis, atopic dermatitis, bronchitis, sensitization (specific IgE, skin tests, nasal challenge tests), total IgE levels, spirometry performed through stress test (positive with a decrease of FEV1 > 15 % with stress or an increase of FEV1 of 12 % after bronchodilation) and family history of allergic disease. A total of 135 medical records of patients with allergic rhinitis were reviewed. Of these, 68 did not report symptoms of bronchial asthma (35 men and 33 women aged between 4 and 18 years). Most of our patients (50/68) reported perennial asthma and were sensitized to mites (44/68). In 14/68 spirometry was not performed at diagnosis. Stress test was positive in 13/54 (24 %). All patients who showed bronchial hyperreactivity were sensitized to mites and only one of these reported seasonal rhinitis. Conclusions: According to the latest guidelines on the treatment and control of allergic rhinitis ­The Allergic Rhinitis and its Impact on Asthma Workshop Report­ bronchial asthma and allergic rhinitis are distinct manifestations of a single airway and of the same disease. In view of our results, we recommend systematic evaluation of bronchial hyperreactivity in the study protocol of allergic rhinitis in patients who do not report symptoms of bronchial asthma.
Keywords: Rinitis alérgica. Hiperreactividad bronquial.

Full Text


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INTRODUCCION

Las enfermedades alérgicas tienen una base inmunológica común. La mayoría de pacientes con asma bronquial y/o rinitis tienen atopia cutánea y sensibilización a aeroalergenos. Todos estos síntomas son manifestaciones de la misma patología en distintos órganos diana, coexistiendo con frecuencia distintas afecciones. La hiperreactividad bronquial es una característica fisiopatológica del asma, pero no exclusiva de esta enfermedad. Las pruebas de hiperreactividad bronquial pueden ser positivas en enfermedades como: bronquiectasias, fibrosis quística y rinitis alérgica, entre otras1,2. El desarrollo del documento "Allergic Rhinitis and its Impact on Asthma workshop report" (ARIA)3 se incide en el hecho de que la mucosa respiratoria es toda ella una unidad. La presencia de una predisposición genética junto a la exposición a determinados estímulos ambientales dará lugar a mecanismos inflamatorios que serán la causa de la hiperreactividad bronquial. El objetivo de nuestro estudio es determinar si los pacientes diagnosticados de rinitis alérgica, en nuestra consulta, sin clínica de asma presentan hiperreactividad bronquial (HRB), así como observar que alergenos son los causantes de esta clínica en nuestros pacientes.

MATERIAL Y MÉTODOS

Estudio retrospectivo y observacional. La población en estudio son los pacientes diagnosticados de rinitis alérgica sin síntomas de asma, en la Unidad de Alergología entre agosto del 2000 y diciembre del 2001. La recogida de datos se ha realizado mediante la revisión de...


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L Valdesoiro a, M Bosque a, MT Marco a, O Asensio a, J Antón a, H Larramona a,

a Unidad de Alergia. Inmunología Clínica y Neumología Pediátrica. Hospital de Sabadell. Corporació Sanitaria Parc Taulí. Barcelona. España.
Journal: Rinitis alérgica e hiperreactividad bronquial

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