Medicina clinica · 2003
[Clinical characteristics of the fatal and near-fatal asthma in Alternaria alternata sensitized patients].
Сравнительное исследованиеАннотация на английскомСтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Plaza Vicente, Serrano José, Picado César, Cosano Javier, Ancochea Julio, de Diego Alfredo, Martín Juan José, Sanchís Joaquín, Grupo de Investigadores del Estudio Multicéntrico del Asma de Riesgo Vital
Аннотация
BACKGROUND AND OBJECTIVE: Some studies have pointed to Alternaria alternata as a trigger of fatal and near-fatal asthma (NFA) crises. The objective of this study was to determine the clinical characteristics of fatal and NFA crisis in patients sensitized to Alternaria.
PATIENTS AND METHOD: One hundred ninety four patients with fatal or NFA attacks were enrolled in a multicenter (33 Spanish hospitals), prospective study. We gathered the characteristics and clinical course of the crises. We performed the following tests: spirometry, prick-test to common allergens, and specific IgE to Alternaria when patients were in stable condition. The sensitization test to Alternaria was performed when the prick-test and/or specific IgE levels were positive.
RESULTS: Twenty (10%) patients were sensitized to Alternaria. When compared to non-sensitized patients, Alternaria sensitized patients were significantly younger, 35 (15) vs 50 (21) years old (p<0.001); their hospital admission length was shorter, 6.5 (5.5) against 9 (7) days (p=0.039); they had a higher number of deaths or severe neurological sequelae, 15 vs 3% (p=0.026); they had a higher sensitization frequency to the remaining allergens, 68 against 22% (p=0.003); and they exhibited a fewer bronchodilation response upon inhaled salbutamol, 6 vs 10% (p=0.013).
CONCLUSIONS: The clinical characteristics of Alternaria sensitised, fatal-and NFA-patients, seem to identify a particular phenotype. Specific avoidance strategies could be useful to prevent fatal and NFA attacks.
PATIENTS AND METHOD: One hundred ninety four patients with fatal or NFA attacks were enrolled in a multicenter (33 Spanish hospitals), prospective study. We gathered the characteristics and clinical course of the crises. We performed the following tests: spirometry, prick-test to common allergens, and specific IgE to Alternaria when patients were in stable condition. The sensitization test to Alternaria was performed when the prick-test and/or specific IgE levels were positive.
RESULTS: Twenty (10%) patients were sensitized to Alternaria. When compared to non-sensitized patients, Alternaria sensitized patients were significantly younger, 35 (15) vs 50 (21) years old (p<0.001); their hospital admission length was shorter, 6.5 (5.5) against 9 (7) days (p=0.039); they had a higher number of deaths or severe neurological sequelae, 15 vs 3% (p=0.026); they had a higher sensitization frequency to the remaining allergens, 68 against 22% (p=0.003); and they exhibited a fewer bronchodilation response upon inhaled salbutamol, 6 vs 10% (p=0.013).
CONCLUSIONS: The clinical characteristics of Alternaria sensitised, fatal-and NFA-patients, seem to identify a particular phenotype. Specific avoidance strategies could be useful to prevent fatal and NFA attacks.