Mehmet Atilla UYSAL, Rana IŞIK, Derya ÜNAL, Güngör ÇAMSARI, Elif Yelda NİKSARLIOĞLU

Prevalence of atopy and allergic rhinitis in patients with adult non-cystic fibrosis bronchiectasis

Background/aim: Non-cystic fibrosis bronchiectasis (non-CF BR) is common in developing countries. Limited data are availableregarding the impact of atopy, and no data are available regarding allergic rhinitis in patients with adult bronchiectasis. The aim of thisstudy was to evaluate the prevalence of atopy and allergic rhinitis in the clinical conditions of patients with BR.Materials and methods: The study enrolled 101 patients who were diagnosed with non-CF BR using high-resolution computed chesttomography. Allergic rhinitis (AR) was defined by skin prick test (SPT) positivity and the presence of any nasal symptoms (watery runnynose, nasal obstruction, nasal itching, and sneezing).Results: The mean age of patients was 48 ± 15 years (range 18–82); 55 (54.5%) patients were female. SPT positivity was detected in 37(36.6%) cases. AR was detected in 32 (31.7%) patients with non-CF BR. AR was related to dyspnea (P = 0.04) and number of admissionsto an emergency department in the previous year (P = 0.01). Forced expiratory volume in 1 s and forced vital capacity in patients withand without AR were different (P = 0.01 and P = 0.01, respectively). AR was correlated with number of admissions to an emergencydepartment in the last year (r = 0.417, P = 0.005).Conclusion: We concluded that atopy was detected in more than one-third of adult non-CF BR patients. This study demonstrated thatnon-CF BR patients might have AR; it might be important to be aware of nasal symptoms in non-CF BR patients.

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1. Barker AF. Bronchiectasis. N Engl J Med 2002; 346: 1383-1393.
2. Pasteur MC, Bilton D, Hill AT; British Thoracic Society Bronchiectasis Non-CF Guideline Group. British Thoracic Society guideline for non-CF bronchiectasis. Thorax 2010; 65 (Suppl. 1): i1-58.
3. Baldacci S, Omenaas E, Oryszcyn MP. Allergy markers in respiratory epidemiology. Eur Respir J 2001; 17: 773-790.
4. Pang J, Chan HS, Sung JY. Prevalence of asthma, atopy and bronchial hyperreactivity in bronchiectasis: a controlled study. Thorax 1989; 44: 948-951.
5. Ozturk S, Tozkoparan E, Karaayvaz M, Caliskaner Z, Gulec M, Deniz O, Ucar E, Ors F, Bozlar U. Atopy in patients with bronchiectasis: More than coincidence. Tohoku J Exp Med 2006; 208: 41-48.
6. Brozek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, Brignardello-Peterson R, Canonica GW, Casale T, Chavnnes NH et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2016 revision. J Allergy Clin Immunol 2017; 140: 950-958.
7. Accordini S, Corsico AG, Calciano L, Bono R, Cerveri I, Fois A, Pirina P, Tassinari R, Veriato G, de Marco R. The impact of asthma, chronic bronchitis and allergic rhinitis on allcause hospitalizations and limitations in daily activities: a population-based observational study. BMC Pulm Med 2015; 15: 10-18.
8. Guilemany JM, Alobid I, Angrill J, Ballesteros F, BernalSprekelsen M, Picado C, Mullol J. The impact of bronchiectasis associated to sinonasal disease on quality of life. Respir Med 2006; 100: 1997-2003.
9. Guilemany JM, Angrill J, Alobid I, Centellas S, Pujols L, Batra J, Bernal-Sprekelsen M, Vlalero A, Picado C, Mullol J. United Airways again: High prevalence of rhinosinusitis and nasal polyps in bronchiectasis. Allergy 2009; 64: 790-797.
10. Chalmers JD, Goeminne P, Aliberti S, McDonnell MJ, Lonni S, Davidson J, Poppelwell L, Salih W, Pesci A, Dupont LJ et al. The bronchiectasis severity index: An international derivation and validation study. Am J Respir Crit Care Med 2014; 189: 576-585.
11. McDonnel MJ, Aliberti S, Goeminne PC, Restrepo M, Finch S, Pesci A, Dupont LJ, Fardon TC, Wilson R, Loebinger MR et al. Comorbidities and the risk of mortality in patients with bronchiectasis: an international multicenter cohort study. Lancet Respir Med 2016; 4: 969-979.
12. Bousquet J, Heinzerling L, Bachert C, Papadopoulos NG, Boisquet PJ, Burney PG, Canonica GW, Cox L, Haahtela T, Lodrup Carlsen KC et al. Global Allergy and Asthma European Network: allergic rhinitis and its impact on asthma. Practical guide to skin prick tests in allergy to aeroallergens. Allergy 2012; 67: 18-24.
13. Kaplan A. Canadian guidelines for chronic rhinosinusitis. Can Fam Physician 2013; 59: 1275-1281.
14. Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, Cohen N, Douglas R, Gevaert P, Georgalas C et al. EPOS 2012: European position paper on rhinisinusitis and nasal polyps 2012: A summary for otorhinolaryngologists. Rhinology 2012; 50: 1-12.
15. Pang J, Chan HS, Sung JY. Prevalence of asthma, atopy and bronchial hyperreactivity in bronchiectasis: a controlled study. Thorax 1989; 44: 948-951.
16. Murphy MB, Reen DJ, Fitzgerald MX. Atopy, immunological changes and respiratory function in bronchiectasis. Thorax 1984; 39: 179-184.
17. Varpela E, Laitinen LA, Keskinen H, Korhola O. Asthma, allergy and bronchial hyper-reactivity to histamine in patients with bronchiectasis. Clin Allergy 1978; 8: 273-280.
18. Ozdemir N, Ucgun I, Metintas S, Kolsuz M, Metintas M. The prevalence of asthma and allergy among university freshmen in Eskisehir, Turkey. Respir Med 2000; 94: 536-541.
19. Celik G, Mungan D, Bavbek S, Sin B, Ediger D, Demirel Y, Misirligil Z. The prevalence of allergic diseases and atopy in Ankara, Turkey: a two-step population-based epidemiological study. J Asthma 1999; 36: 281-290.
20. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. Fontana, WI, USA: GINA; 2017.
21. Bisaccioni C, Aun MV, Cajuela E, Kalil J, Agondi RC, GiavinaBianchi P. Comorbidities in severe asthma: frequency of rhinitis, nasal polyposis, gastroesophageal reflux disease, vocal cord dysfunction and bronchiectasis. Clinics (Sao Paulo) 2009; 64: 769-773.
22. Ramakrishnan VR, Ferril GR, Suh JD, Woodson T, Green TJ, Kingdom TT. Upper and lower airways associations in patients with chronic rhinosinusitis and bronchiectasis. Int Forum Allergy Rhinol 2013; 3: 921-927.
23. Kalyoncu AF, Demir AU, Ozcakar B, Bozkurt B, Artvinli M. Asthma and allergy in Turkish university students: two crosssectional surveys 5 years apart. Allergol Immunopathol 2001; 29: 264-271.
24. Kurt E, Metintas S, Basyigit I, Bulut I, Coskun E, Dabak S, Deveci F, Fidan F, Kaynar H, Kunt Uzaslan E et al. Prevalence and risk factors of allergies in Turkey (PARFAIT): results of a multicentre cross-sectional study in adults. Eur Respir J 2009; 33: 724-733.
25. Brandao HE, Cruz CMS, Santos Junior IS, Ponte EV, Gumaraes A, Augusto Filho A. Hospitalizations for asthma: impact of a program for the control of asthma and allergic rhinitis in Feira de Santana, Brazil. J Bras Pneumol 2009; 35: 723-729.
26. Adam RJ, Fuhlbrigge AL, Finkelstein JA, Weiss ST. Intranasal steroids and the risk of emergency department. J Allergy Clin Immunol 2002; 109: 636-642.
27. Corren J, Manning BE, Thompson SF, Hennessy S, Strom BL. Rhinitis therapy and the prevention of hospital care for asthma: a case-control study. Allergy Clin Immunol 2004; 113: 415-419.
28. Aliberti S, Lonni S, Dore S, McDonnell MJ, Goeminne PC, Dimakou K, Fardon TC, Rutherford R, Pesci A, Restrepo MI et al. Clinical phenotypes in adult patients with bronchiectasis. Eur Respir J 2016; 47: 1113-1122.
29. Yang X, Xu Y, Jin J, Li R, Liu X, Sun Y. Chronic rhinosinusitis is associated with higher prevalence and severity of bronchiectasis in patients with COPD. Int J COPD 2017; 12: 655-662.
30. Bergqvist J, Andersson A, Olin AC, Murgia N, Schiöler L, Bove M, Hellgren J. New evidence of increased risk of rhinitis in subjects with COPD: a longitudinal population study. Int J COPD 2016; 11: 2617-2623.
31. Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Greenberger PA, Khan DA, Lang DM, Park HS, Pichler W et al. International consensus on drug allergy. Allergy 2014; 69: 420-437.
32. Ensina LFC, Amigo MHL, Koch T, Guzman E, Paoli R, Nunes IC. Drug hypersensitivity in students from Sao Paulo, Brazil. Clinics (Sao Paulo) 2010; 65: 1009-1011.