Allergy rhinitis: similarities and differences between children and adults.

BACKGROUND: Allergic rhinitis (AR) is a highly prevalent disease worldwide. Although a number of studies have described AR, no studies compared children and adult AR populations. The objective was to compare the AR characteristics between two AR cohorts of children and adults. METHODS: Two AR cohorts (children and adults) from Spain were studied through observational cross-sectional multicentre studies. AR was classified based on classical (allergen exposure), original (o-ARIA), and modified (m-ARIA) ARIA criteria. AR was evaluated by Total 4-Symptoms Score (T4SS), and disease severity by Visual Analogue Scale (VAS, 0-100 mm). AR comorbidities were also evaluated. RESULTS: A total of 5,405 patients (1,275 children, 4,130 adults) were studied. According to symptoms duration, intermittent AR was more frequent in children than in adults. Using o-ARIA severity, more children than adults had moderate/severe AR while, using m-ARIA, more children than adults had severe AR. T4SS was higher in adults than in children. Moreover, VAS was also higher in adults than in children. In addition, asthma atopic dermatitis and conjunctivitis were more associated to children than adults with AR, the frequency of this comorbidities increasing according to higher severity. CONCLUSIONS: AR in children was more intermittent, severe, with less symptoms but with more comorbidities than in adults. These results suggest AR has similarities but also significant differences between children and adults.

Clinical and immunological effects of immunotherapy with glutaraldehyde modified house dust mite extract.

The aim of this study was to demonstrate the clinical effectiveness of treatment with specific immunotherapy using allergenic mite extracts modified with glutaraldehyde. The results showed an improvement both in clinical symptoms and a reduction in the complementary pharmacological therapy used. Several clinical "in vitro" and "in vivo" parameters were analysed during this study. The results obtained from the Nasal Challenge Test and the Skin Test (prick-test) were the most relevant. Patient tolerance to the diagnostic extract was increased in 45% of the patients, the result of which was registered in the Nasal Challenge Test. Evaluation of the results derived from the skin tests on conclusion of immunotherapy, showed a reduction in response in 55% of the patients. Progressive immunotherapeutic doses were applied at short intervals with no record of severe reactions.

[Bronchial asthma caused by occupational sulfite exposure]. / Asma bronquial por exposición laboral a sulfitos.

A case is reported of a patient with episodes of bronchospasm requiring hospital admission after handling sodium bisulfite on the job. The patient had a 15-year history of bronchial asthma and concomitant rhinoconjunctivitis and a 6-year history of asthma induced by moderate exercise. His family history included a father with sensitization to mites. Skin tests, measurement of specific IgI, and nasal provocation were positive for domestic dust mites and grass pollen. Skin tests for sodium metasulfite at a concentration of 10 mg/ml were negative. A simple blind oral provocation test of sodium metasulfite (1, 5, 20, and 50 mg) in acid medium was positive at the 50-mg dose, eliciting bronchial and nasal symptoms, and a decrease in CVF, FEV1, and PEF of more than 20% over baseline values. The episode of bronchospasm has not recurred in the workplace since exposure to sodium bisulfite was eliminated. Oral provocation with metasulfite in acid medium is considered a good technique for confirming the diagnosis of these cases.