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Churg-Strauss Syndrome in Japan
Abstracts AB207
J ALLERGY CLIN IMMUNOL VOLUME 131, NUMBER 2
Childhood Asthma Profile in Participants of Asthma Control Program Gesmar Segundo1,2, Juliana Ribeiro1; 1Universidade Federal de Uberlandia, Uberlandia, Brazil, 2Centro Universitario de Patos de Minas, Patos de Minas, Brazil. RATIONALE: This study has aimed to describe the clinical features and verify the allergen sensitization profile of the skin prick test (SPT) in patients with asthma who were followed in Asthma Control Program of Catal~ao. METHODS: An observational study was conducted from June 2010 to June 2011 with children age 2-15 years that visit the doctors in the period of study. Data related with clinical and epiodemiologic aspects were obtained by questionnaire and electronic medical records. A SPT to major allergens was performed in all participants. RESULTS: In a total of 301 study participants, 57% were male and had a median age of 74 months. In 80% of cases, at least one first-degree relative was atopic, 88% had clinical symptoms of rhinitis and passive smoking was found in 29% of the patients homes. The most prevalent aeroallergens were Dermatophagoides pteronissinus (44%), Dermatophagoides farinae (43%) and Blomia tropicalis(35%). The sensitization to at least one aeroallergen was present in 63% of patients. By ages, there was predominance of sensitization asthma in patients over 5 years old and non-sensitization asthma between 2 and 5 years old, with p<0,0001. Older patients spend more time between symptoms and treatment and presented more severe disease. CONCLUSIONS: It was shown that the higher prevalence of nonsensitized asthma under 5years that coincides with other cohort studies of asthma in childhood. It is suggest and reinforce that asthma may have different patterns according to age, changing the prognosis and severity of the disease.
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Churg-Strauss Syndrome in Japan Shunsei Hirohata; Kitasato University School of Medicine, Sagamihara, Japan. RATIONALE: Epidemiological data on Churg-Strauss syndrome (CSS) in Japan have not been available. We therefore carried out a retrospective cohort study on patients in Tokyo metropolitan area. METHODS: All the patients fulfilled the diagnostic criteria for CSS of the Japanese research committee of intractable vasculitis. Certificated medical records for application of medical subsidy between October 2002 and September 2006 were reviewed. RESULTS: A total of 74 patients were collected, aged 57.3 6 14.6 years (Mean 6 SD), consisting of 19 males and 55 females. The ages of onset of CSS were 56.6 6 14.9 years. The preceding allergic symptoms were bronchial asthma in 63.5%, allergic rhinitis in 5.4%, and both in 31.1%. As to the vasculitic manifestations, mononeuritis multiplex was most common (93%), followed by purpura (36.5%), fever (33.8%), body weight loss (29.7%), polyarthritis (28.4%), gastrointestinal bleeding (18.9%), but no renal damages. Eosiophilia, elevation of serum IgE, positive rheumatoid factors and positive MPO-ANCA were observed in 100%, 88.2%, 70.3% and in 48.6%, respectively. Most patients (93.2%) responded to moderate doses of prednisolone alone, whereas methyl prednisolone pulse therapy and immunosuppressant therapy were given in 39.2% and in 12.2%, respectively. CONCLUSIONS: The results highlight the characterstic demographic features of Japanese patients with CSS, especially the female dominance and the high prevalence of mononeuritis multiplex. Moreover, the paucity of renal damages in spite of the high prevalence of MPO-ANCA suggest that there are some factors which protect the kidney from MPO-ANCAmediated damages in CSS.
739
An Application of Computerized Asthma-Specific QOL in Korean Asthmatics Kim Mi-Ae1, Ye Young-Min1, Park Jung-Won2, Lee Jae-Hyun2, Lee SooKeol3, Kim Cheol-Woo4, Jung Ki-Suck5, Kim Joo-Hee5, Yoo Hye-Soo1, Lee Seung Ihm1, Kim Seung-Hyun1, Shin Yoo Seob1, Park Hae-Sim1; 1 Ajou University School of Medicine, Suwon, South Korea, 2Yonsei University College of Medicine, Seoul, South Korea, 3Dong-A University College of Medicine, Pusan, South Korea, 4Inha University College of Medicine, Incheon, South Korea, 5Hallym University Medical School, Pyungchon, South Korea. RATIONALE: Proper assessment of health-related quality of life (HRQOL) is an essential issue to achieve and maintain well control status in asthmatic patients. We developed our own scale of cAQOL based on personal interviews with Korean adult asthmatics. In this study, we validated cAQOL in aspects of asthma control status and ACT score, which were compared with AQLQ. METHODS: A multi-center prospective study for 24 weeks was done in an outpatient population of asthma and allergy clinics from 2010 to 2012. 150 subjects in total were recruited from five university hospitals in South Korea and randomized into 2 groups according to operating order of cAQOL and AQLQ. At every 3 months’ visits, physicians evaluated asthma control status with monitoring spirometry. The self-administered cAQOL, AQLQ and ACT were completed. RESULTS: The cAQOL scales correlated closely with ACT scores with statistical significances (r50.804; p<0.001). The ROC curve demonstrated _19 ACT) that cAQOL was superior for predicting poorly controlled state (< with high sensitivity and specificity (81.9%, 72.9%, respectively) compared to AQLQ. The predictable factors for asthma exacerbation could be 1% change of inverse cAQOL scale and comorbid of allergic rhinitis with statistical significance (p<0.05. respectively). Among the 6 domains of cAQOL, DC domain (difficulties related to cough) was the most significant one (p 5 0.025). CONCLUSIONS: The cAQOL is a reliable instrument to evaluate HRQOL and can be used for predicting asthma control status and exacerbation in Korean adult asthmatics.
740
Reproducibility of Acq-7 Questionnaire in the Assessment of Asthma Control Mariana N. Cardoso, MD1, Herberto J. Chong Neto, MD, PhD, FAAAAI1, Carlos Antonio Riedi, MD, PhD1, Nelson A. Rosario, MD, PhD, FAAAAI1,2; 1Federal University of Parana, Curitiba, Brazil, 2Federal University of Parana, Curitiba, Brazil. RATIONALE: To determine the reproducibility of ACQ-7 (Asthma Control Questionnaire-7) in patients with asthma and compare with the criteria of GINA for asthma with and without control, Updated 2011. _12 year-old in outpatient METHODS: The study involved individuals > treatment and diagnosis of asthma by GINA. Evaluation was performed in two visits with an interval of 2 to 3 weeks between them. At each visit ACQ-7 was answered, spirometer obtained and consultation with a specialist to identify asthma control according to the criteria defined by _0.75 (controlled asthma) and GINA. For ACQ-7, we defined two cutoffs: < _1.5 (uncontrolled asthma). > RESULTS: Fifty-two patients were enrolled, median age 16.5 years, 65% female. Half of them had mild persistent asthma and the others, moderate persistent asthma. The values of ACQ-7 in two visits demonstrated good reproducibility, with correlation coefficient of 0.73. Regarding asthma _0.75, while with GINA control, ACQ-7 identified 16 patients with values < only 3 patients had controlled asthma. In a similar way, the ACQ-7 _1.5, whereas only 2 had uncontrolled identified 23 patients with values > asthma with GINA. By GINA criteria, 47 (90.4%) were classified as having partially controlled asthma. CONCLUSIONS: The ACQ-7 showed good reliability in this population and identified more patients with controlled and uncontrolled asthma than in relation to the criteria of GINA.
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J ALLERGY CLIN IMMUNOL VOLUME 131, NUMBER 2
Childhood Asthma Profile in Participants of Asthma Control Program Gesmar Segundo1,2, Juliana Ribeiro1; 1Universidade Federal de Uberlandia, Uberlandia, Brazil, 2Centro Universitario de Patos de Minas, Patos de Minas, Brazil. RATIONALE: This study has aimed to describe the clinical features and verify the allergen sensitization profile of the skin prick test (SPT) in patients with asthma who were followed in Asthma Control Program of Catal~ao. METHODS: An observational study was conducted from June 2010 to June 2011 with children age 2-15 years that visit the doctors in the period of study. Data related with clinical and epiodemiologic aspects were obtained by questionnaire and electronic medical records. A SPT to major allergens was performed in all participants. RESULTS: In a total of 301 study participants, 57% were male and had a median age of 74 months. In 80% of cases, at least one first-degree relative was atopic, 88% had clinical symptoms of rhinitis and passive smoking was found in 29% of the patients homes. The most prevalent aeroallergens were Dermatophagoides pteronissinus (44%), Dermatophagoides farinae (43%) and Blomia tropicalis(35%). The sensitization to at least one aeroallergen was present in 63% of patients. By ages, there was predominance of sensitization asthma in patients over 5 years old and non-sensitization asthma between 2 and 5 years old, with p<0,0001. Older patients spend more time between symptoms and treatment and presented more severe disease. CONCLUSIONS: It was shown that the higher prevalence of nonsensitized asthma under 5years that coincides with other cohort studies of asthma in childhood. It is suggest and reinforce that asthma may have different patterns according to age, changing the prognosis and severity of the disease.
738
Churg-Strauss Syndrome in Japan Shunsei Hirohata; Kitasato University School of Medicine, Sagamihara, Japan. RATIONALE: Epidemiological data on Churg-Strauss syndrome (CSS) in Japan have not been available. We therefore carried out a retrospective cohort study on patients in Tokyo metropolitan area. METHODS: All the patients fulfilled the diagnostic criteria for CSS of the Japanese research committee of intractable vasculitis. Certificated medical records for application of medical subsidy between October 2002 and September 2006 were reviewed. RESULTS: A total of 74 patients were collected, aged 57.3 6 14.6 years (Mean 6 SD), consisting of 19 males and 55 females. The ages of onset of CSS were 56.6 6 14.9 years. The preceding allergic symptoms were bronchial asthma in 63.5%, allergic rhinitis in 5.4%, and both in 31.1%. As to the vasculitic manifestations, mononeuritis multiplex was most common (93%), followed by purpura (36.5%), fever (33.8%), body weight loss (29.7%), polyarthritis (28.4%), gastrointestinal bleeding (18.9%), but no renal damages. Eosiophilia, elevation of serum IgE, positive rheumatoid factors and positive MPO-ANCA were observed in 100%, 88.2%, 70.3% and in 48.6%, respectively. Most patients (93.2%) responded to moderate doses of prednisolone alone, whereas methyl prednisolone pulse therapy and immunosuppressant therapy were given in 39.2% and in 12.2%, respectively. CONCLUSIONS: The results highlight the characterstic demographic features of Japanese patients with CSS, especially the female dominance and the high prevalence of mononeuritis multiplex. Moreover, the paucity of renal damages in spite of the high prevalence of MPO-ANCA suggest that there are some factors which protect the kidney from MPO-ANCAmediated damages in CSS.
739
An Application of Computerized Asthma-Specific QOL in Korean Asthmatics Kim Mi-Ae1, Ye Young-Min1, Park Jung-Won2, Lee Jae-Hyun2, Lee SooKeol3, Kim Cheol-Woo4, Jung Ki-Suck5, Kim Joo-Hee5, Yoo Hye-Soo1, Lee Seung Ihm1, Kim Seung-Hyun1, Shin Yoo Seob1, Park Hae-Sim1; 1 Ajou University School of Medicine, Suwon, South Korea, 2Yonsei University College of Medicine, Seoul, South Korea, 3Dong-A University College of Medicine, Pusan, South Korea, 4Inha University College of Medicine, Incheon, South Korea, 5Hallym University Medical School, Pyungchon, South Korea. RATIONALE: Proper assessment of health-related quality of life (HRQOL) is an essential issue to achieve and maintain well control status in asthmatic patients. We developed our own scale of cAQOL based on personal interviews with Korean adult asthmatics. In this study, we validated cAQOL in aspects of asthma control status and ACT score, which were compared with AQLQ. METHODS: A multi-center prospective study for 24 weeks was done in an outpatient population of asthma and allergy clinics from 2010 to 2012. 150 subjects in total were recruited from five university hospitals in South Korea and randomized into 2 groups according to operating order of cAQOL and AQLQ. At every 3 months’ visits, physicians evaluated asthma control status with monitoring spirometry. The self-administered cAQOL, AQLQ and ACT were completed. RESULTS: The cAQOL scales correlated closely with ACT scores with statistical significances (r50.804; p<0.001). The ROC curve demonstrated _19 ACT) that cAQOL was superior for predicting poorly controlled state (< with high sensitivity and specificity (81.9%, 72.9%, respectively) compared to AQLQ. The predictable factors for asthma exacerbation could be 1% change of inverse cAQOL scale and comorbid of allergic rhinitis with statistical significance (p<0.05. respectively). Among the 6 domains of cAQOL, DC domain (difficulties related to cough) was the most significant one (p 5 0.025). CONCLUSIONS: The cAQOL is a reliable instrument to evaluate HRQOL and can be used for predicting asthma control status and exacerbation in Korean adult asthmatics.
740
Reproducibility of Acq-7 Questionnaire in the Assessment of Asthma Control Mariana N. Cardoso, MD1, Herberto J. Chong Neto, MD, PhD, FAAAAI1, Carlos Antonio Riedi, MD, PhD1, Nelson A. Rosario, MD, PhD, FAAAAI1,2; 1Federal University of Parana, Curitiba, Brazil, 2Federal University of Parana, Curitiba, Brazil. RATIONALE: To determine the reproducibility of ACQ-7 (Asthma Control Questionnaire-7) in patients with asthma and compare with the criteria of GINA for asthma with and without control, Updated 2011. _12 year-old in outpatient METHODS: The study involved individuals > treatment and diagnosis of asthma by GINA. Evaluation was performed in two visits with an interval of 2 to 3 weeks between them. At each visit ACQ-7 was answered, spirometer obtained and consultation with a specialist to identify asthma control according to the criteria defined by _0.75 (controlled asthma) and GINA. For ACQ-7, we defined two cutoffs: < _1.5 (uncontrolled asthma). > RESULTS: Fifty-two patients were enrolled, median age 16.5 years, 65% female. Half of them had mild persistent asthma and the others, moderate persistent asthma. The values of ACQ-7 in two visits demonstrated good reproducibility, with correlation coefficient of 0.73. Regarding asthma _0.75, while with GINA control, ACQ-7 identified 16 patients with values < only 3 patients had controlled asthma. In a similar way, the ACQ-7 _1.5, whereas only 2 had uncontrolled identified 23 patients with values > asthma with GINA. By GINA criteria, 47 (90.4%) were classified as having partially controlled asthma. CONCLUSIONS: The ACQ-7 showed good reliability in this population and identified more patients with controlled and uncontrolled asthma than in relation to the criteria of GINA.
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