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Allergic Conjunctivitis In Portugal: A Cross-sectional Survey Of Clinical Characteristics And Quality Of-life
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Allergic Conjunctivitis In Portugal: A Cross-sectional Survey Of Clinical Characteristics And Quality Of-life L. Delgado1,2, J. Palmares3, M. Cidade4, M. J. Quadrado5, H. P. Filipe6; 1 Faculdade de Medicina, Universidade do Porto, Porto, PORTUGAL, 2 Immunoallergology Service, Hospital S.Joao, Porto, PORTUGAL, 3Ophthalmology Department, Hospital S Joao, Porto, PORTUGAL, 4Ophthalmology Department4, Hospital de Almada, Almada, PORTUGAL, 5 Ophthalmology Department, Hospitais da Universidade de Coimbra, Coimbra, PORTUGAL, 6Ophthalmology Department, Instituto Gama Pinto, Lisboa, PORTUGAL. RATIONALE: Ocular allergy is one of the most common ocular problems in clinical practice and, although easily identified and frequently a mild to moderate condition, is responsible for health impairment and work/school absenteeism. METHODS: A cross sectional study, based on a structured questionnaire, was performed in 16 ophthalmology departments of central or regional hospitals, in patients diagnosed with allergic conjunctivitis, during the spring of 2006. RESULTS: 220 patients were enrolled (mean age of 31.4 6 18.5 years). A quarter of these patients had >5 episodes of ocular allergy in the past year, 59.3% all year round episodes, and most presented associated co-morbidities (allergic rhinitis 45.9%, asthma 15.5%). They had a significant impairment of their overall quality of life during an acute episode (45.6% 6 in a 10 point severity scale). Only 19.4% had an appointment with the ophthalmologist as a first action and most (56.1%) started with self treatment measures. Only 37.2% had a previous allergy diagnostic evaluation. CONCLUSIONS: We found a significant impairment of the self-rated health status during an ocular allergy episode. Moreover, most patients have recurrent year round episodes, and start its management with self treatment measures.
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Time Trends in the Prevalence of Allergic Diseases in Childhood M. Geraldini1, N. A. Rosario1, C. A. Riedi1, B. B. Leopoldino2, C. S. Rosario1, F. Barkema2, F. Palermo2, G. Macedo1, L. D. K. Kusano1, N. O. Eiras1, R. Robl1, R. P. Schnekenberg1, T. B. Ribeiro1, V. Macedo1; 1University of Parana´, Curitiba, BRAZIL, 2University Positivo, Curitiba, BRAZIL. RATIONALE: The International Study of Asthma and Allergies in Childhood (ISAAC) has shown wide variations (specially increasing) in the prevalence of asthma, allergic rhinoconjunctivitis and atopic eczema in developing countries. The aim of this study was to examine time trends in the prevalence of these allergic diseases in children from Curitiba. METHODS: Three cross-sectional questionnaire surveys (1995, 2001 and 2009) with identical protocols and questionnaires were completed. The methods used followed the published ISAAC manual. Briefly, children 13- to 14-yr olds were chosen from a randomly selected sample of schools. A questionnaire related to symptoms of wheezing, rhinoconjunctivitis and eczema was self-completed by children. Chi square test for trend was applied to verify differences in prevalence. A P-value <0.01 was considered statistically significant. The study was approved by the Ethical Committee of the Clinical Hospital of the University of Parana. RESULTS: The data collection respected the autumn season in the 3 surveys. The number of participants was 2946, 3628 and 3120 in 1995, 2001 and 2009. In 1995 80(2.7%) children reported three or more episodes of wheezing in the last 12 months, 73(2.0%) in 2001 and 170(5.4%) in 2009 (p < 0.01). Sneezing or a runny or blocked nose accompanied by itchy-watery eyes in the absence of a cold or ‘‘the flu’’ was found in 417(14.2%); 625(17.2%) and 592(18.9%), respectively (p < 0.01). Recurrent itchy rush in the folds affected 111(3.8%); 133(3.7%) and 221(7.08%) (p < 0.01). CONCLUSIONS: A significant increase in the prevalence of asthma, rhinoconjunctivitis and eczema has been observed in our population in the last 8 years.
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Maternal Obesity, Prematurity, and Cord Blood IgE Levels R. Kumar1, L. Arguelles1, X. Hong1, G. Wang2, L. Burdea1, J. A. Pongracic1, X. Wang1; 1Children’s Memorial Hospital, Chicago, IL, 2The University of Illinois at Chicago, School of Public Health, Chicago, IL. RATIONALE: In the US, maternal obesity and preterm delivery complicate 20 and 12.5% of pregnancies respectively. We sought to determine whether maternal obesity was associated with cord blood IgE (cbIgE) or early life atopic diseases, and whether the association differs by prematurity. METHODS: We analyzed data from 1191 infants with cbIgE in an inner city, prospective birth cohort. Maternal BMI was determined by standardized prenatal questionnaire and categorized per CDC classification as underweight, normal, overweight, and obese. Large for gestational age (LGA) infants had a standardized birth weight greater than the 90%ile. Linear regressions, stratified by term and preterm (<37 weeks gestation) delivery, evaluated the association of maternal BMI with cbIgE, controlling for maternal (including age, race, atopy, education and smoking) and infant (gender and LGA) variables. Logistic regression evaluated the association of maternal obesity with physician diagnosed eczema, and food allergy. RESULTS: Maternal obesity and LGA were present in 20.7% and 9.7% of the deliveries respectively, and 23.2% of deliveries were preterm. In preterm infants only, maternal obesity was associated with lower cord blood IgE (b,95%CI 5 -0.78,-1.51 to -0.06). With the inclusion of LGA in these regressions, the effect remained significant (b,95%CI 5 -0.90,-1.71 to -0.01). There was a non-significant trend for an interaction between prematurity and maternal obesity (p 5 0.15). Maternal obesity was not associated with food allergy or eczema. CONCLUSIONS: In this inner city birth cohort, maternal obesity is associated with a lower cbIgE levels in preterm infants only. Maternal obesity is not a risk factor for early life atopic outcomes (food allergy and eczema).
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Clinical Manifestations of Elevated IgE Levels in Hospitalized Patients J. Kenaya, E. Sykes, C. Lauter; William Beaumont Hospital, Royal Oak, MI. RATIONALE: Unusually high total IgE levels (>1000 IU/mL) are found in a limited number of medical conditions in industrialized countries. Most studies have been done on outpatients. The clinical associations of IgE levels over 1000 IU/mL were investigated for inpatients of a large community hospital. METHODS: The paper and electronic medical records of inpatients with total IgE tests between 1/1/07-12/31/08 were screened. Of 195 patients, 36 had total IgE >1000 IU/mL; these cases were analyzed. RESULTS: During the same time frame 5,375 total IgE levels were ordered on outpatients. Twenty-one of the 36 inpatients with IgE >1000 IU/mL were female, 16 were Caucasian and 26 were over 18-years-old. Twenty-nine of 36 were atopic including three with ABPA. Twenty-three had asthma, 12 had eczema and 11 had food allergies. Other co-morbidities included esophageal disorders - 8, other dermatoses - 7 and cancer in five patients. Indications for the test included asthma-12, eosinophilia-12 and worsening eczema in six patients. Fourteen tests were ordered by allergists, but 24/36 patients had allergy consultations. Total IgE values ranged from 1,074 - 19,695 IU/mL; the mean was 4,613 IU/mL. Nine of 36 patients died during the follow up including 4/9 during the same hospitalization. For 7/9 patients who died, sepsis was listed as the primary diagnosis. CONCLUSIONS: Atopic inpatients with total IgE >1000 IU/mL were similar to outpatients. Serious allergic and non-allergic comorbidities were common and 9/36 inpatients died during the follow up period. The unexpected mortality (25%) of inpatients with unusually high total IgE levels requires further investigation.
SATURDAY
Abstracts AB31
J ALLERGY CLIN IMMUNOL VOLUME 125, NUMBER 2
Allergic Conjunctivitis In Portugal: A Cross-sectional Survey Of Clinical Characteristics And Quality Of-life L. Delgado1,2, J. Palmares3, M. Cidade4, M. J. Quadrado5, H. P. Filipe6; 1 Faculdade de Medicina, Universidade do Porto, Porto, PORTUGAL, 2 Immunoallergology Service, Hospital S.Joao, Porto, PORTUGAL, 3Ophthalmology Department, Hospital S Joao, Porto, PORTUGAL, 4Ophthalmology Department4, Hospital de Almada, Almada, PORTUGAL, 5 Ophthalmology Department, Hospitais da Universidade de Coimbra, Coimbra, PORTUGAL, 6Ophthalmology Department, Instituto Gama Pinto, Lisboa, PORTUGAL. RATIONALE: Ocular allergy is one of the most common ocular problems in clinical practice and, although easily identified and frequently a mild to moderate condition, is responsible for health impairment and work/school absenteeism. METHODS: A cross sectional study, based on a structured questionnaire, was performed in 16 ophthalmology departments of central or regional hospitals, in patients diagnosed with allergic conjunctivitis, during the spring of 2006. RESULTS: 220 patients were enrolled (mean age of 31.4 6 18.5 years). A quarter of these patients had >5 episodes of ocular allergy in the past year, 59.3% all year round episodes, and most presented associated co-morbidities (allergic rhinitis 45.9%, asthma 15.5%). They had a significant impairment of their overall quality of life during an acute episode (45.6% 6 in a 10 point severity scale). Only 19.4% had an appointment with the ophthalmologist as a first action and most (56.1%) started with self treatment measures. Only 37.2% had a previous allergy diagnostic evaluation. CONCLUSIONS: We found a significant impairment of the self-rated health status during an ocular allergy episode. Moreover, most patients have recurrent year round episodes, and start its management with self treatment measures.
121
Time Trends in the Prevalence of Allergic Diseases in Childhood M. Geraldini1, N. A. Rosario1, C. A. Riedi1, B. B. Leopoldino2, C. S. Rosario1, F. Barkema2, F. Palermo2, G. Macedo1, L. D. K. Kusano1, N. O. Eiras1, R. Robl1, R. P. Schnekenberg1, T. B. Ribeiro1, V. Macedo1; 1University of Parana´, Curitiba, BRAZIL, 2University Positivo, Curitiba, BRAZIL. RATIONALE: The International Study of Asthma and Allergies in Childhood (ISAAC) has shown wide variations (specially increasing) in the prevalence of asthma, allergic rhinoconjunctivitis and atopic eczema in developing countries. The aim of this study was to examine time trends in the prevalence of these allergic diseases in children from Curitiba. METHODS: Three cross-sectional questionnaire surveys (1995, 2001 and 2009) with identical protocols and questionnaires were completed. The methods used followed the published ISAAC manual. Briefly, children 13- to 14-yr olds were chosen from a randomly selected sample of schools. A questionnaire related to symptoms of wheezing, rhinoconjunctivitis and eczema was self-completed by children. Chi square test for trend was applied to verify differences in prevalence. A P-value <0.01 was considered statistically significant. The study was approved by the Ethical Committee of the Clinical Hospital of the University of Parana. RESULTS: The data collection respected the autumn season in the 3 surveys. The number of participants was 2946, 3628 and 3120 in 1995, 2001 and 2009. In 1995 80(2.7%) children reported three or more episodes of wheezing in the last 12 months, 73(2.0%) in 2001 and 170(5.4%) in 2009 (p < 0.01). Sneezing or a runny or blocked nose accompanied by itchy-watery eyes in the absence of a cold or ‘‘the flu’’ was found in 417(14.2%); 625(17.2%) and 592(18.9%), respectively (p < 0.01). Recurrent itchy rush in the folds affected 111(3.8%); 133(3.7%) and 221(7.08%) (p < 0.01). CONCLUSIONS: A significant increase in the prevalence of asthma, rhinoconjunctivitis and eczema has been observed in our population in the last 8 years.
122
Maternal Obesity, Prematurity, and Cord Blood IgE Levels R. Kumar1, L. Arguelles1, X. Hong1, G. Wang2, L. Burdea1, J. A. Pongracic1, X. Wang1; 1Children’s Memorial Hospital, Chicago, IL, 2The University of Illinois at Chicago, School of Public Health, Chicago, IL. RATIONALE: In the US, maternal obesity and preterm delivery complicate 20 and 12.5% of pregnancies respectively. We sought to determine whether maternal obesity was associated with cord blood IgE (cbIgE) or early life atopic diseases, and whether the association differs by prematurity. METHODS: We analyzed data from 1191 infants with cbIgE in an inner city, prospective birth cohort. Maternal BMI was determined by standardized prenatal questionnaire and categorized per CDC classification as underweight, normal, overweight, and obese. Large for gestational age (LGA) infants had a standardized birth weight greater than the 90%ile. Linear regressions, stratified by term and preterm (<37 weeks gestation) delivery, evaluated the association of maternal BMI with cbIgE, controlling for maternal (including age, race, atopy, education and smoking) and infant (gender and LGA) variables. Logistic regression evaluated the association of maternal obesity with physician diagnosed eczema, and food allergy. RESULTS: Maternal obesity and LGA were present in 20.7% and 9.7% of the deliveries respectively, and 23.2% of deliveries were preterm. In preterm infants only, maternal obesity was associated with lower cord blood IgE (b,95%CI 5 -0.78,-1.51 to -0.06). With the inclusion of LGA in these regressions, the effect remained significant (b,95%CI 5 -0.90,-1.71 to -0.01). There was a non-significant trend for an interaction between prematurity and maternal obesity (p 5 0.15). Maternal obesity was not associated with food allergy or eczema. CONCLUSIONS: In this inner city birth cohort, maternal obesity is associated with a lower cbIgE levels in preterm infants only. Maternal obesity is not a risk factor for early life atopic outcomes (food allergy and eczema).
123
Clinical Manifestations of Elevated IgE Levels in Hospitalized Patients J. Kenaya, E. Sykes, C. Lauter; William Beaumont Hospital, Royal Oak, MI. RATIONALE: Unusually high total IgE levels (>1000 IU/mL) are found in a limited number of medical conditions in industrialized countries. Most studies have been done on outpatients. The clinical associations of IgE levels over 1000 IU/mL were investigated for inpatients of a large community hospital. METHODS: The paper and electronic medical records of inpatients with total IgE tests between 1/1/07-12/31/08 were screened. Of 195 patients, 36 had total IgE >1000 IU/mL; these cases were analyzed. RESULTS: During the same time frame 5,375 total IgE levels were ordered on outpatients. Twenty-one of the 36 inpatients with IgE >1000 IU/mL were female, 16 were Caucasian and 26 were over 18-years-old. Twenty-nine of 36 were atopic including three with ABPA. Twenty-three had asthma, 12 had eczema and 11 had food allergies. Other co-morbidities included esophageal disorders - 8, other dermatoses - 7 and cancer in five patients. Indications for the test included asthma-12, eosinophilia-12 and worsening eczema in six patients. Fourteen tests were ordered by allergists, but 24/36 patients had allergy consultations. Total IgE values ranged from 1,074 - 19,695 IU/mL; the mean was 4,613 IU/mL. Nine of 36 patients died during the follow up including 4/9 during the same hospitalization. For 7/9 patients who died, sepsis was listed as the primary diagnosis. CONCLUSIONS: Atopic inpatients with total IgE >1000 IU/mL were similar to outpatients. Serious allergic and non-allergic comorbidities were common and 9/36 inpatients died during the follow up period. The unexpected mortality (25%) of inpatients with unusually high total IgE levels requires further investigation.
SATURDAY
Abstracts AB31
J ALLERGY CLIN IMMUNOL VOLUME 125, NUMBER 2