Assessment of clinical phenotypic characteristics of patients with angioedema without wheals in a turkish population.

Background: Angioedema (AE) is defined as localized, self-limited swelling of subcutaneous tissues and mucosa. Objective: The aim of this study was to compare the phenotypic characteristics of patients with AE without wheals. Methods: This prospective study included adult patients with recurrent AE without wheals. Demographic and laboratory data of the patients were recorded in the patient file when they presented to the outpatient clinic between August 2018 and August 2020. The patients were contacted by phone to evaluate whether their AE had gone into remission between October 2023 and January 2024. The phenotypic characteristics of AE subtypes were compared. Results: The study included a total of 143 patients. The average age, age of onset of AE, rates of diabetes mellitus, hypertension and coronary artery disease were higher in the patients with angiotensin-converting enzyme inhibitor (ACEI) use related acquired AE (AAE) (AAE-ACEI). The rates of allergic rhinitis, drug allergy, atopy, and aeroallergen sensitivity, and the median total immunoglobulin E level were higher in patients with idiopathic histaminergic AAE (AAE-IH). The rate of face and/or perioral AE attacks was higher in the patients with AAE-ACEI, AAE-IH, and idiopathic non-histaminergic AAE. The rate of AE attacks in limbs, abdominal, genital and other parts of the body was higher in patients with hereditary AE (HAE). The baseline AE activity score was lower in the patients with AAE-IH and higher in the patients with HAE. In long-term follow-up, the remission rate of AE attacks was significant higher in patients with AAE-ACEI and AAE-IH. Conclusion: The phenotypic characteristic features of Turkish patients with AE without wheals may vary, depending on the underlying AE pathogenesis. C1 inhibitor level and function, complement C4 and C1q, and genetic tests contributed to the diagnosis; other laboratory tests did not contribute to the diagnosis.

Long-term use of omalizumab in patients with allergic bronchopulmonary aspergillosis: a tertiary-level care center experience.

INTRODUCTION: Allergic bronchopulmonary aspergillosis (ABPA) is a lung disease caused by a hypersensitivity reaction to antigens of Aspergillus fumigatus. OBJECTIVE: The aim of this study was to evaluate the long-term clinical outcomes of omalizumab use in patients with ABPA. METHODS: In this retrospective study, 12 patients diagnosed with ABPA and receiving omalizumab for at least 2 years, and 32 patients diagnosed with severe allergic asthma and receiving omalizumab for at least 2 years (control group) were evaluated. RESULTS: Evaluation was made of a total of 44 participants, comprising 11 (25%) males and 33 (75%) females, who received omalizumab for at least 2 years with the diagnosis of the control group (n = 32) and ABPA (n = 12). The increase in asthma control test (ACT) score after omalizumab was significant at 12 months and at 24 months in patients with ABPA. After omalizumab, the use of oral corticosteroid (OCS), the annual number of asthma attacks and hospitalizations were significantly decreased at 12 months and at 24 months in patients with ABPA. The increase in forced expiratory volume in 1 s (FEV1) (%) and ACT score after omalizumab were significant at 12 months and at 24 months in the control group. After omalizumab, the use of OCS, annual number of asthma attacks and hospitalizations were significantly decreased at 12 months and at 24 months in the control group. CONCLUSION: Long-term omalizumab use in patients with ABPA seems to be an effective treatment for improving pulmonary function and reducing asthma exacerbations and hospitalizations.

Successful treatment using agalsidase alfa of a patient with Fabry disease who had anaphylaxis after agalsidase beta: A case report.

Fabry disease is a rare genetic disease caused by a deficiency of α-galactosidase A gene (α-Gal A). Two intravenous enzymes administered every two weeks, agalsidase alfa and beta can slow disease progression and increase survival if administered early, before organ damage occurs. In this case report, we present a patient with a history of anaphylaxis to agalsidase beta who was successfully treated with agalsidase alfa.

Comparison of the General Characteristics of Patients with Severe Asthma Who Switched from Omalizumab to Mepolizumab versus Patients Who Responded to Omalizumab Treatment: A Real-Life Study.

INTRODUCTION: Severe asthma is characterized by frequent recurrent airway symptoms and exacerbations, and these affect the quality of life. Biological agents can be used in the treatment of patients with severe asthma if the disease cannot be controlled with standard controller treatment. The aim of this study was to compare the clinical characteristics and laboratory data of patients with severe asthma who were switched from omalizumab to mepolizumab and patients with severe asthma who responded to omalizumab. METHODS: The clinical characteristics and laboratory data of patients with severe asthma who responded to omalizumab and switched from omalizumab to mepolizumab were compared retrospectively. RESULTS: Evaluation was made of a total of 79 patients, including 64 omalizumab responders and 15 who switched to mepolizumab from omalizumab. After omalizumab and mepolizumab treatment, the annual number of asthma attacks, the use of oral corticosteroid (OCS), the annual number of hospitalizations, and the eosinophil count significantly decreased (omalizumab: p < 0.001, p < 0.001, p < 0.001, p < 0.001, respectively; mepolizumab: p = 0.001, p = 0.001, p = 0.002, p = 0.001, respectively). After omalizumab treatment, the increase in forced expiratory volume in 1 s (FEV1) (%) and asthma control test (ACT) score were determined to be statistically significant (p < 0.001, p < 0.001, respectively). After mepolizumab treatment, the increase in ACT score was significant (p = 0.003). Drug allergy, chronic sinusitis with nasal polyps (CRSwNP), regular use of OCS, and high baseline eosinophil count (cells/µL) were associated with poor response to omalizumab treatment (odds ratio [OR] = 7.86, p = 0.003; OR = 52.92, p < 0.001; OR = 10.16, p = 0.004; OR = 0.99, p = 0.004, respectively). House dust mite sensitivity and high baseline FEV1 (%) were associated with good response to omalizumab treatment (OR = 0.29, p = 0.041; OR = 1.06, p = 0.03, respectively). The blood eosinophil count had diagnostic value in predicting the nonresponsiveness to omalizumab treatment (area under the curve [AUC]: 0.967, p < 0.001, cut-off: 510). CONCLUSION: A high pretreatment eosinophil count, concomitant CRSwNP, a history of drug allergy, and regular OCS use may be associated with poor response to omalizumab treatment in patients with severe asthma. Depending on the treatment response, treatment switching can be applied between biological agents. The results of the current study should be supported by multicenter studies.

A Case-Control Study Comparing the General Characteristics of Patients with Symptomatic Dermographism and Chronic Spontaneous Urticaria: Is Atopy a Risk Factor for Symptomatic Dermographism?

INTRODUCTION: Symptomatic dermographism (SDerm) is the most common chronic inducible urticaria (CIndU) subtype. There is still limited information in the literature about clinical features, triggering factors, and accompanying comorbidities of SDerm. The aim of this study was to compare the clinical features and laboratory data of patients with SDerm and chronic spontaneous urticaria (CSU). METHODS: The clinical features and laboratory data of patients with SDerm and CSU were compared retrospectively. The laboratory data and general characteristic features of the patients were obtained from the medical records. RESULTS: The study included a total of 361 patients (CSU: 220, SDerm: 141). The rates of asthma (odds ratio [OR]: 1.79, p = 0.036), allergic rhinitis (OR: 6.03, p < 0.001), and thyroid disease (OR: 1.78, p = 0.039) were higher in patients with SDerm. The disease duration (median 12 months, p < 0.001) and regular antihistamine use (OR: 0.31, p < 0.001) were lower in patients with SDerm. Total IgE level (median: 193, p < 0.001), thyroid antibody positivity (OR: 1.93, p = 0.039), and atopy (OR: 8.81, p < 0.001) were higher in patients with SDerm. Dermatophagoides pteronyssinus (OR: 17.72, p < 0.001), Dermatophagoides farinae (OR: 17.20, p < 0.001), grass pollen (OR: 2.50, p < 0.026), cat epithelium (OR: 3.68, p < 0.023), and cockroach (OR: 4.93, p < 0.009) allergen positivity rates were higher in patients with SDerm. CONCLUSION: Atopic diseases such as asthma and allergic rhinitis and the sensitization rate to aeroallergens seem to be higher in patients with SDerm than in patients with CSU. The results of this study should be supported by multicenter studies of patients from different geographical regions.

Drug Reaction with Eosinophilia and Systemic Symptom Syndrome Due to Everolimus: A Case Report.

Drug reaction with eosinophilia and systemic symptom (DRESS) is a life-threatening drug hypersensitivity reaction that is characterized by skin rash, hematological abnormalities (eosinophilia, atypical lymphocytosis), lymphadenopathy, and internal organ involvement (liver, kidneys, and lung). Many drugs may cause DRESS syndrome, the most frequently reported of which are antiepileptics and allopurinol. In this case report, a patient who developed DRESS syndrome due to everolimus was presented herein.

Thermo-SPT: A new skin prick test evaluation framework based on low-cost, portable smartphone thermography.

BACKGROUND: Although the skin prick test (SPT) is a reliable procedure to confirm IgE-dependent allergic sensitization in patients, the interpretation of the test is still performed manually, resulting in an error-prone procedure for the diagnosis of allergic diseases. OBJECTIVE: To design and implement an innovative SPT evaluation framework using a low-cost, portable smartphone thermography, named Thermo-SPT, to significantly improve the accuracy and reliability of SPT outcomes. METHODS: Thermographical images were captured every 60 s for a duration of 0 to 15 min using the FLIR One app, and then analysed with the FLIR Tool® . The definition of 'Skin Sensitization Region' area was introduced to analyse the time-lapse thermal changes in skin reactions over several time periods during the SPT. The Allergic Sensitization Index (ASI) and Min-Max Scaler Index (MMS) formulae were also developed to optimize the identification of the peak allergic response time point through the thermal assessment (TA) of allergic rhinitis patients. RESULTS: In these experimental trials, a statistically significant increase in temperature was detected from the fifth minute of TA for all tested aeroallergens (all p values < .001 ). An increase was observed in the number of false-positive cases, where patients with clinical symptoms not consistent with SPT were evaluated as positive on TA assessment, specifically for patients diagnosed with Phleum pratense and Dermatophagoides pteronyssinus. Our proposed technique, the MMS, has demonstrated improved accuracy in identifying P. pratense and D. pteronyssinus compared with other SPT evaluation metrics, specifically starting from the fifth minute. For patients diagnosed with Cat epithelium, although not statistically significant initially, an increasing trend was determined in the results at the 15 min (ΔT (T15 - T0 ), p = .07 ; ASIT15 , p < .001 ). CONCLUSIONS: This proposed SPT evaluation framework utilizing a low-cost, smartphone-based thermographical imaging technique can enhance the interpretability of allergic responses during the SPT, potentially reducing the need for extensive manual interpretation experience as standard SPTs.

Evaluation of the clinical features and laboratory data of patients with severe asthma classified as super-responder or non super-responder to omalizumab treatment: a single-center real-life study.

INTRODUCTION: Omalizumab is used for the treatment of severe allergic asthma. OBJECTIVE: The aim of this study was to evaluate the clinical features and laboratory data of patients with severe allergic asthma classified as super-responder or non super-responder to omalizumab. METHODS: Comparisons were made of the laboratory data and clinical features of patients with severe allergic asthma. Patients who had no asthma exacerbation, no oral corticosteroid (OCS) use, asthma control test (ACT) score >20 and forced expiratory volume in 1 s (FEV1) >80% were considered super-responder after omalizumab. RESULTS: A total of 90 patients were included in the study, comprising 19 (21.1%) males. The age at onset of asthma, allergic rhinitis rate, number of endoscopic sinus surgeries (ESS), intranasal corticosteroid (INS) use, baseline FEV 1 (%) and ACT score were significantly higher in the omalizumab super-responder group (p = 0.013, p = 0.015, p = 0.002, p = 0.001, p = 0.001 and p < 0.001, respectively). The duration of asthma, rate of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP), regular use of OCS, baseline eosinophil count and eosinophil-to-lymphocyte ratio were significantly higher in the omalizumab non super-responder group (p = 0.015, p < 0.001, p = 0.004, p < 0.001 and p < 0.001, respectively). Blood eosinophil count (AUC: 0.187, p < 0.001), eosinophil-to-lymphocyte ratio (AUC: 0.150, p < 0.001) and FEV1 (%) (AUC:0.779, p = 0.001) were determined to have diagnostic value in predicting the treatment response to omalizumab of patients with severe allergic asthma. CONCLUSION: High-blood eosinophil levels, CRSwNP and low pretreatment lung capacity may affect omalizumab treatment response in patients with severe allergic asthma. These results should be supported by further multicenter real-life studies.

Evaluation of the Clinical Features and Laboratory Data of Patients with Severe Eosinophilic Asthma Classified as Super-Responders, Partial Responders, or Nonresponders to Mepolizumab Treatment: A Real-Life Study.

INTRODUCTION: Mepolizumab is a treatment option in patients with severe eosinophilic asthma, which inhibits interleukin-5. The aim of this study was to evaluate the clinical features and laboratory data of patients with severe eosinophilic asthma who were classified as super-responders, partial responders, or nonresponders to mepolizumab treatment. METHODS: In this retrospective real-life study, the clinical features and laboratory data were compared between groups of patients with severe eosinophilic asthma who were classified as super-responders, partial responders, or nonresponders to mepolizumab treatment. RESULTS: Evaluation was made of a total of 55 patients, comprising 17 (30.9%) males and 38 (69.1%) females with a mean age of 51.28 ± 14.32 years. All the patients were receiving mepolizumab treatment for severe eosinophilic asthma, with 17 (30.9%) patients evaluated as super-responders, 26 (47.3%) as partial responders, and 12 (21.8%) as nonresponders. After mepolizumab treatment, there was a statistically significant decrease in asthma exacerbations, the number of oral corticosteroids (OCSs) used, the rate of hospitalization due to asthma attacks, and the eosinophil count (cells/µL) (p < 0.001, p < 0.001, p < 0.001, and <0.001, respectively). A statistically significant increase was determined in the forced expiratory volume in 1 s (FEV1) value (p = 0.010) and asthma control test (ACT) score (p < 0.001) after mepolizumab treatment. The baseline eosinophil count, eosinophil/lymphocyte ratio and FEV1 (%) values were significantly higher in the super-responder and partial responder groups (p < 0.001, p = 0.002, and p = 0.002, respectively). The baseline ACT score and the rate of chronic sinusitis with nasal polyps were significantly higher in the partial responder group (p = 0.004, p = 0.015, respectively). The rate of regular OCS use before mepolizumab treatment was significantly higher in the nonresponder group (p = 0.049). As a result of the receiver operating characteristics curve analysis, the blood eosinophil count (area under the curve [AUC]: 0.967, p < 0.001), eosinophil/lymphocyte ratio (AUC: 0.921, p < 0.001), and FEV1 (%) (AUC: 0.828, p = 0.002) were found to have diagnostic value in predicting the response to mepolizumab treatment in patients with severe eosinophilic asthma. CONCLUSION: Baseline eosinophil count, eosinophil/lymphocyte ratio, and FEV1 (%) were found to be important predictors of response to mepolizumab treatment. Further studies are needed to define the characterization of mepolizumab responders in the real world.

Comparison of Omalizumab Treatment Response in Patients with Chronic Spontaneous Urticaria and Symptomatic Dermographism: A Single-Center Retrospective Study.

INTRODUCTION: Omalizumab is a humanized anti-IgE monoclonal antibody, which is effective in the treatment in patients with chronic spontaneous urticaria (CSU) who are unresponsive to antihistamine therapy. There are few studies in the literature evaluating omalizumab treatment response in patients with symptomatic dermographism (SDerm). The aim of this study was to compare the response to omalizu-mab treatment in patients with CSU and SDerm. METHODS: Patients treated with omalizumab for the diagnosis of CSU and SDerm were evaluated retrospectively. Treatment response to omalizumab was evaluated with the urticaria control test (UCT). Quality of life was evaluated with the dermatology quality of life questionnaire (DLQI). Baseline UCT and DLQI were compared with UCT and DLQI after omalizumab treatment. RESULTS: Evaluation was made of a total of 116 patients (CSU: 92, SDerm: 24), comprising 36 (31%) males and 80 (69%) females with a mean age of 38.95 ± 13.64 years. The most common accompanying comorbid disease was allergic rhinitis (n = 40, 34.5%). There was no statistically significant difference between patients with CSU and SDerm in respect of response to omalizumab treatment (p = 0.890). After omalizumab treatment, the increase in UCT and decrease in DLQI was statistically significant in all patient groups (p < 0.001; p < 0.001, respectively), patients with CSU (p < 0.001; p < 0.001, respectively) and SDerm (p < 0.001; p < 0.001, respectively). There was no statistically significant difference between baseline (before omalizumab treatment) UCT (p = 0.804) and UCT after omalizumab treatment (p = 0.933) between patients with CSU and patients with SDerm. There was no statistically significant difference between baseline (before omalizumab treatment) DLQI (p = 0.356) and DLQI after omalizumab treatment (p = 0.145) between patients with CSU and patients with SDerm. CONCLUSION: Omalizumab treatment improved disease control and quality of life in patients with SDerm. The findings of this study should be supported by randomized placebo-controlled studies.

Which non-steroidal anti-inflammatory drug (NSAID) is safer in patients with Non-steroids Exacerbated Respiratory Disease (N-ERD)? A single-center retrospective study.

Introduction: In patients with NSAID-Exacerbated Respiratory Disease (N-ERD), respiratory symptoms occur as a result of the use of cyclooxygenase (COX)-1 inhibitor non-steroidal anti-inflammatory drugs (NSAIDs). Patients with N-ERD generally tolerate selective COX-2 inhibitor NSAIDs. However, respiratory symptoms may be exacerbated in patients with N-ERD due to the intake of selective COX-2 inhibitor NSAIDs. The aim of this study was to evaluate which selective or partial COX-2 inhibitor NSAID is safer in patients with N-ERD. Materials and Methods: Forty-nine patients with a history of respiratory hypersensitivity reactions to NSAIDs (N-ERD) who underwent a drug challenge test with celecoxib, nimesulide, meloxicam, and paracetamol between January 2021-April 2022 were retrospectively evaluated. Result: Of the 49 patients who underwent the drug challenge tests, 16 (32.7%) were male and 33 (67.3%) were female and the mean age was 37.67 ± 11.62 years. The most common comorbidities were chronic urticaria [n= 21 (42.9%)] and allergic rhinitis [n= 21 (42.9%)]. As a result of drug challenge tests, celecoxib, nimesulide, meloxicam, and paracetamol drug challenge tests were positive in 2 (4.1%), 8 (16.3%), 7 (14.3%) and 11 (22.4) patients, respectively. The rate of allergic reaction to celecoxib was statistically significantly lower than other drugs (p= 0.001). In paired comparisons of the drugs, the allergic reaction rate with celecoxib was statistically significantly lower than with nimesulide (p= 0.031) and paracetamol (p= 0.004). Conclusions: Selective COX-2 inhibitor NSAIDs are safe in patients with N-ERD. NSAIDs should be prescribed to these patients following general medical precautions and drug challenge tests.

Comparison of the Patients with Chronic Urticaria Who Responded and Did Not Respond to Omalizumab Treatment: A Single-Center Retrospective Study.

INTRODUCTION: Chronic urticaria (CU) is a condition usually lasting longer than 6 weeks, with wheals and angioedema, sometimes both. Omalizumab is a recombinant humanized monoclonal IgG antibody developed against IgE. In some patients with CU, treatment response to omalizumab is good, but in some patients, it is poor. We aimed to compare the clinical features and laboratory parameters of the patients who responded and did not respond to omalizumab treatment among patients diagnosed with CU. METHODS: Patients treated with omalizumab for the diagnosis of CU were evaluated retrospectively. Treatment response to omaliz-umab was evaluated by urticaria control test (UCT) (responder to omalizumab: UCT score ≥12 at 6 months and an increase of ≥3 compared to baseline). The clinical features and laboratory parameters of the patients who responded and did not respond to treatment were compared. RESULTS: The mean age of the 220 patients, 66 (30%) men and 154 (70%) women, who received 300 mg of sc omalizumab every 4 weeks for CU was 38.89 ± 12.76 years. One hundred eighty-nine (85.9%) patients had good response to omalizumab treatment at the end of 6 months. Atopy (n = 73 [38.6%], p = 0.026), eosinophil count (median = 190 [0-800] [cells/µL], p < 0.001), basophil count (median = 40 [0-100] [cells/µL], p = 0.021), and total IgE (median = 240.5 [45-2,644] [kU/L], p < 0.001) level were significantly higher in the omalizumab responder patients (UCT score ≥12 at 6 months and an increase of ≥3 compared to baseline). Psychiatric disorders (n = 13 [41.9%], p = 0.008) and anti-TG (n = 11 [35.5%] [>2 IU/mL positive], p = 0.024) were significantly higher in the oma-lizumab nonresponder patients (UCT score ≤11 at 6 months). A weak but significant clinical correlation was found between blood eosinophil count (r = 0.168, p = 0.013), blood lymphocyte count (r = -0.149, p = 0.027), total IgE level (r = 0.207, p = 0.002), and increase in UCT score. As a result of the ROC curve analysis, the blood eosinophil count (AUC: 0.763, p < 0.001), total IgE level (AUC: 0.866, p < 0.001), and blood basophil count (AUC: 0.662, p = 0.004) had diagnostic value in predicting the response to omalizumab treatment in patients with CU. CONCLUSION: The patients with CU who were atopic with high eosinophils, high basophils, and high total IgE levels had good response to omalizumab treatment, but the patients with concomitant psychiatric disease and positive thyroid autoantibodies had poor response to omalizu-mab treatment. These findings obtained in our study should be tested in randomized controlled studies.

Severe asthma concomitant with allergic bronchopulmonary aspergillosis (ABPA) and non-steroid exacerbated respiratory disease (N-ERD) successfully treated with mepolizumab: A case report.

Allergic bronchopulmonary aspergillosis (ABPA) is a lung disease characterized by a hypersensitivity reaction to Aspergillus fumigatus. Allergic bronchopulmonary aspergillosis is characterized by increased serum IgE levels, peripheral blood eosinophilia and radiographic pulmonary infiltrates, central bronchiectasis, and mucus plugs. Mepolizumab, a monoclonal interleukin (IL)-5 antibody, reduces eosinophilic inflammation and improves symptom control in severe eosinophilic asthma. A 74-year-old male patient arrived at our allergy outpatient clinic complaining of shortness of breath and cough. He had a history of asthma, NSAIDs Exacerbated Respiratory Disease (N-ERD) and endoscopic sinus surgery (ESS) due to chronic sinusitis with nasal polyps (CRSwNPs). At the time of admission to our clinic, his asthma control test (ACT) score was 5. The laboratory test results= eosinophil count (cells/mcL)= 570, total IgE= 3976 IU/mL, Aspergillus-specific IgE= 1.87 kIU/L (>0.35 positive). In the pulmonary function tests, forced expiratory volume in 1s (FEV1) was 28%. Thoracic computed tomography of the patient revealed central cystic bronchiectatic areas and mucus plugs. The patient was diagnosed with ABPA. The case reported here is of a patient diagnosed with severe asthma concomitant with ABPA and N-ERD, who was successfully treated with mepolizumab. Randomized double-blind placebo-controlled studies are needed to evaluate the efficacy of mepolizumab treatment in these patients.

Short- and long-term oral steroid therapy in patients with asthma exacerbation.

Steroids are frequently used for symptom control in cases of asthma exacerbation. The aim of this study was to compare the effect of short-term and long-term oral steroid therapy on symptom control in patients with asthma exacerbation. Patients that received short-term (<10 d) and long-term (≥10 d) oral steroid therapy during asthma exacerbation were compared retrospectively. A visual analog scale (VAS) for symptom severity was administered, and the asthma control test (ACT) and pulmonary function tests were performed before and after treatment. The study included 69 patients and the overall mean duration of steroid treatment was 9.57±3.58 d (range: 5-25 d). Mean duration of short-term and long-term steroid treatment was 6.54±0.99 d and 11.63±3.21 d, respectively. Serious side-effects were not observed following oral steroid therapy. Post the short- and long-term oral steroid therapy there were not any significant differences between the 2 groups in terms of ACT, FEV1 (forced expiratory volume 1), or VAS symptom scores. The findings show that in patients with mild asthma exacerbation short-term oral steroid therapy is as effective as long-term steroid therapy and can be safely used for symptom control during periods of mild asthma exacerbation.

The association of timothy grass allergy and cat ownership on cat sensitization.

Background: Pollen hypersensitivity might be a determining factor for other nonseasonal allergens because it may indicate deviation of the immune system toward T-helper type 2 activity and immunoglobulin E sensitivity. Objective: To investigate whether timothy grass pollen allergy may be a predictive factor for cat sensitization and whether there is an association between sensitivity to both allergens. Method: A retrospective review was made of patients with symptoms of rhinitis. The skin-prick test results and cat ownership status of the patients were analyzed. On the basis of the skin-prick test results with Phleum pratense (timothy grass) and other pollens, the patients were analyzed in two groups: "timothy allergic" and "non-timothy allergic." Results: A total of 383 patients with the diagnosis of rhinitis were included in the study, which comprised 213 (55.6%) in the timothy allergic group and 170 (44.4%) in the non-timothy allergic group. The frequency of cat sensitization was significantly higher in the patients in the timothy allergic group compared with those without timothy grass allergy (33.8% versus 12.3%; p < 0.001). No significant difference was determined between the two groups in terms of cat ownership (p = 0.63). In the logistic regression analysis, cat ownership (adjusted odds ratio [OR] 23.07 [95% confidence interval {CI}, 7.72-68.91]) and timothy allergy (adjusted OR 7.72 [95% CI, 3.16-18.86]) were associated with an increased risk of cat sensitization. Conclusion: Timothy grass allergy may play a role in the development of cat sensitization; however, further research is needed to clarify these associations and the underlying mechanisms.

The course of COVID-19 in patients with severe asthma receiving biological treatment.

OBJECTIVE: In order to decrease the use of systemic corticosteroids and prevent asthma exacerbations, EAACI and GINA made recommendations in favor of severe asthma patients continuing the use of biologicals during the pandemic. However, the course of SARS-CoV-2 infection remains uncertain, especially in patients taking biological therapy for severe asthma. The aim of this study was to demonstrate the clinical course of COVID-19 in severe asthmatic patients receiving biological treatment. METHODS: A total of 75 patients under the care of a tertiary level allergy clinic and receiving omalizumab or mepolizumab, which are the approved biologicals for severe asthma in Turkey, were included in the survey between April 1 and December 31, 2020. A questionnaire was administered via a telephone call by one of the treating physicians. RESULTS: Of the total patients, 46 (61%) were receiving mepolizumab and 29 (39%) omalizumab. Of the patients, 14 (19%) had COVID-19, 9 (64%) had pneumonia, 4 (29%) were hospitalized. A total of 12 (16%) patients interrupted biological treatments because they did not want to attend hospital for injections during the pandemic. The incidence of COVID-19 was higher in patients who have interrupted biological treatment (p < 0.001). In addition, the risk of having COVID-19 was higher in the ones who have interrupted their biological treatment (Relative risk:2.71; 95% Confidence interval:1.21-6.06). Asthma control was better in patients attending regular injections (p = 0.006). CONCLUSION: Severe asthma itself seems to be a risk factor for COVID-19, whether biological treatment has a role in the disease course needs further research.

Regular Treatment With Aspirin 300 mg/day After Desensitization in Patients With N-ERD: 12-Year Results.

OBJECTIVE: Aspirin desensitization is recommended for patients with nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity, in whom asthma is uncontrolled despite medical treatment, and/or frequent endoscopic sinus surgery (ESS) is required due to nasal polyps. There are few studies in the literature on long-term follow-up of patients undergoing regular aspirin treatment after desensitization. This study aims to evaluate the effect of regular aspirin treatment on respiratory function, symptom control, quality of life, and the number of nasal surgeries required during a period of 12 years. MATERIAL AND METHODS: A total of 18 patients were included in the study in 2006; 11 patients were excluded and 7 patients regularly taking aspirin for 12 years were evaluated. Oral aspirin desensitization was performed at 4-6 weeks following the ESS. Patients receiving 300 mg/day aspirin were followed up in control visits every 3 months. Nasal and respiratory system examinations and pulmonary function test were performed, and all patients responded to the SF-36 Quality of Life scale during each visit. RESULTS: There was no change in respiratory function parameters following the12-year aspirin treatment. There was no statistically significant improvement in the quality of life; however, the need for ESS due to the recurrence of nasal polyps decreased significantly (P = .000). At the 12-year follow-up, all symptom scores improved, but improvement in the postnasal drip score was statistically significant (P = .046). CONCLUSION: Long-term regular treatment with aspirin at a dose of 300 mg/day in patients with N-ERD improved symptom scores, and alleviated the need for ESS due to nasal polyp recurrence.