Chieira, C

Faria, E

Loureiro, C

Loureiro, G

Santos, A

Sousa, N

Tavares, B

Name not available

Chronic rhinosinusitis with nasal polyps in allergic patients

Repositório Institucional dos Hospitais da Universidade de Coimbra

independently of asthma severity, gender,age, and tobacco habit.Asthma treatmentprescribed for Spanish Primary Care Physi-cians were: combined inhaled corticosteroidsand beta-agonist (62%), antil-leucotrienes(34%), inhaled corticosteroids alone (26%),and oral corticosteroids (5%) while 8%received no treatment. Drugs more com-moly prescribed for rhinitis were: antihista-mines (45%), intranasal corticosteroids(32%), antileucotrienes (15%), while 7%received no treatment.Conclusions: In Spanish Primary Care Phy-sicians outpatient clinics, asthmatic patientspresent a high prevalence of rhinitis (71%),these patients being younger and asthma lesssevere. A significant relationship was ob-served between the severity of asthma andrhinitis and between atopy with rhinitis andasthma, although rhinitis treatment asso-ciated was no related with a better lungfunction.As recommended by guidelinesstrategies to investigate and treat concomi-tant rhinitis and asthma should beconsidered.1643Comorbidity of Asthma and Rhinitis in theoutpatient clinic of SpanishPneumologists (The Rinair Study)Castillo, J1; Mullol, J21Institut Universitari Dexeus, Grupo de Rinitis-Area deAsma SEPAR, Pneumology and Allergy Department,Barcelona, Spain, 2Hospital Clı´nic, Grupo de Rinitis-Areade Asma SEPAR, Rhinology Unit, ENT Department,IDIBAPS, CIBERes, Barcelona, SpainBackground: Asthma and rhinitis are linkedby common inflammatory processes ofupper and lower airways, often co-exist inthe same patients and rhinitis treatment inasthmatic patients may improve asthmamanagement. The aim of this study was toinvestigate the prevalence and characteris-tics of rhinitis in asthma patients attendingoutpatient clinic of Spanish Pneumologist.Methods: Asthmatic patients (n5 703) wereprospectively evaluated for rhinitis symp-toms, severity, lung function, atopy, asthmaexacerbations, and treatment of asthma andrhinitis, in a longitudinal study carried outin 2005–2006 performed by 15% of SpanishPneumologist (n5 172), randomly distribu-ted in Spain.Results: Among asthmatic patients, 71%had concomitant rhinitis. Patients withrhinitis were generally younger(43.8 vs.55.4 years old; Po0.001) and their asthmawas less severe (FEV1%: 85.7 vs. 79.7; Po0.001) than those without rhinitis. A sig-nificant correlation (r5 0.33; Po0.0001)was foud between the severity of rhinitisand the severity of asthma. Sensitisation tospecific allergens was strongly associated toasthma with rhinitis (OR5 6.25;95%CI54.3–9.1). The prevalence of concomitantrhinitis was higher in atopic (84%, Po0.001) than non-atopic (51%) asthmatics.Using multivariant analysis, patients withtreatted rhinitis had better lung function(FEV1%: 87.3 vs. 83.4, P5 0.057)thanthose without treatment, independently ofasthma severity, gender, age, and tobaccohabit. Asthma teatment prescribed by Span-ish Pneumologist was: combined inhaledcorticosteroids and beta-agonists(72%),anti-leucotrienes (32%), inhaled corticoster-oids alone (20%), oral corticosteroids(3.4%), and inmunotherapy (2.8%) while8.1% received no treatment. Drugs morecommonly prescribed for rhinitis were:intranasal corticosteroids (38%), antihista-mines (30%), anti-leucotrienes (18%), and12% received no treatment.Conclusions: In Spanish Pneumonologistoutpatient clinics, asthmatic patients presenta high prevalence of rhinitis (71%), thesepatients being younger and having anasthma less severe. There exist a significantrelationship between the severity of asthmaand rhinitis and between atopy with rhinitisand asthma. The treatment of rhinitis wasalso associated with better pulmonary func-tion. As recommended by guidelenes, stra-tegies to investigate and treat concomitantrhinitis and asthma should be considered.1644Chronic rhinosinusitis with nasal polyps inallergic patientsSousa, N; Santos, A; Loureiro, G; Tavares, B; Loureiro, C;Faria, E; Chieira, CCoimbra University Hospitals, ImmunoallergologyDepartment, Coimbra, PortugalBackground: Chronic Rhinosinusitis withnasal polyps (NPs) affects 4% of the generalpopulation in the Western world, with theincidence in asthmatics being as high as30%. Our aim was to characterize theclinical pattern of patients with NPs attend-ing our Immunoallergology Department.Methods: The clinical files of patients with adiagnosis of NPs attending our Immunoal-lergology consultation in the last 12 monthswere reviewed, with special attention to theclinical history, the presence and severity ofasthma, the presence of aspirin hypersensi-tivity, total IgE level, peripheral eosinophilcount, SPT results and finally medical andsurgical treatment. The patients were di-vided into 3 groups depending on theexistence or absence of asthma and aspirinhypersensitivity – Group 1 presented noasthma or hypersensitivity to aspirin, Group2 presented asthma without aspirin hyper-sensitivity, and finally Group 3 presentedWidal’s triad.Results: Fifty-five clinical files were re-viewed (58.5% F). The results are summar-ized in the following table:Fifteen patients from group 3 had beensubmitted to challenge tests – 11 of themtolerated NSAIDs other than aspirin,namely nimesulide, meloxicam and coxibs.Conclusion: The overall incidence of asthmain our population with nasal polyps was84%, which is much higher than thatreported, which can be explained by thenature of our consultation. The patientswith Widal’s Triad clearly had more severeasthma than the other groups. It was also inthis group that the majority of SPT werenegative (80%). There was also a predomi-nance in female patients with this syndrome.These results appear to be in line with thepublished literature.Table 1 for abstract 1644.Group 1 Group 2 Group 3F/M 9 (3F/6M) 21 (13F/8M) 25 (16F/9M)Mean Age 447 15.1 49.17 15.4 55.77 11.8Intermittent asthma 7 (33%) 4 (16%)Mild persistent asthma 5 (23%) 3 (12%)Moderate persistent asthma 3 (14%) 4 (16%)Severe persistent asthma 6 (29%) 13 (52%)Nasal obstruction 9 (100%) 21 (100%) 25 (100%)Hyposmia 5 (56%) 6 (29%) 11 (44%)Nasal discharge 7 (78%) 11 (52%) 10 (40%)Headache 4 (44%) 8 (38%) 6 (24%)Positive SPT aeroallergens 4 (44%) 13 (62%) 5 (20%)Nasal corticosteroids (CS) 9 (100%) 21 (100%) 25 (100%)Oral CS 1 (11%) 4 (19%) 6 (24%)Anti-leukotrienes 3 (33%) 15 (71%) 8 (32%)Anti-histamines 3 (33%) 9 (43%) 9 (36%)Nasal douche 3 (33%) 5 (24%) 4 (16%)1 Surgery 4 (44%) 6 (29%) 9 (36%)2 surgeries 0% 6 (29%) 2 (8%)43 surgeries 1 (11%) 2 (10%) 2 (8%)Poster Group 3 – Pathogenetic Mechanisms in Rhinitis and Comorbiditiesr 2008 The AuthorsJournal Compilation r 2008 Blackwell Munksgaard Allergy 63 (Suppl. 88): 158–611594

Chronic rhinosinusitis with nasal polyps in allergic patients

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Repositório Institucional dos Hospitais da Universidade de Coimbra