Prevalence of allergic rhinitis and its impact on the use of emergency care services in a group of children and adolescents with moderate to severe persistent asthma

Abstract

ResumoObjetivos: Avaliar a prevalência da rinite alérgica (RA) e os fatores associados à utilização de serviços de pronto-atendimento por asma aguda em crianças e adolescentes asmáticos tratados com corticóide inalatório. Métodos:Foi realizado um estudo transversal, do qual participaram 126 pacientes que se encontravam em tratamento com o dipropionato de beclometasona por 3 anos. Através de modelos de regressão logística, foram avaliados os fatores associados à consulta de pronto-atendimento no terceiro ano de tratamento com dipropionato de beclometasona. Resultados:A prevalência da rinite alérgica foi de 74,6% (IC95% 65,9-81,7). A presença de rinite alérgica (OR = 2,98, IC95% 1,10-8,06) e a gravidade da asma (OR = 2,09, IC95% 1,05-4,44) foram fatores independentes para consultas em pronto-atendimento. Conclusão:A rinite alérgica apresentou elevada prevalência no grupo estudado e, aliada à gravidade da asma, foi o principal fator de risco para as consultas de pronto-atendimento. Os serviços de saúde deveriam ficar atentos para o reconhecimento precoce da rinite alérgica nos pacientes com asma.J Pediatr (Rio J). 2007;83(6):555-561: Asma, rinite alérgica, consultas em pronto-atendimento, corticóide inalatório. AbstractObjective: To assess the prevalence of allergic rhinitis and the factors associated with the use of emergency care services by children and adolescents with acute asthma submitted to inhaled corticosteroid therapy. Methods:A cross-sectional study was conducted with 126 patients treated with beclomethasone dipropionate for 3 years. The factors associated with emergency care services in the third year of beclomethasone dipropionate treatment were assessed using logistic regression models. Results:The prevalence of allergic rhinitis amounted to 74.6% (95%CI 65.9-81.7). The presence of allergic rhinitis (OR = 2.98, 95%CI 1.10-8.06) and asthma severity (OR = 2.09, 95%CI 1.05-4.44) were independent factors for emergency care services. Conclusion:The prevalence of allergic rhinitis was high and that, combined with asthma severity, constituted the major risk factor for the necessity of emergency care services. Health professionals should attempt to make an early diagnosis of allergic rhinitis in asthmatic patients.J Pediatr (Rio J). 2007;83(6):555-561: Asthma, allergic rhinitis, emergency care services, inhaled corticosteroids. IntroduçãoA asma e a rinite alérgica (RA) são manifestações de um processo inflamatório único das vias aéreas 1,2 . A literatura tem demonstrado que a RA está presente em 75 a 80% dos pacientes com asma 3,4 .As consultas em pronto-atendimento são responsáveis por apenas 1% dos custos diretos com a RA, mas respondem 1. Doutora. Professora adjunta.

Hospitalizações por asma: impacto de um programa de controle de asma e rinite alérgica em Feira de Santana (BA)

“…(20) Studies have shown that rhinitis and asthma are interrelated, and that the appropriate treatment of allergic rhinitis improves asthma control, decreasing symptoms and reducing the risk of emergency room visits and hospitalizations. (21)(22)(23)(24)(25) Indeed, 35 children in the ProAR-FS with mild asthma (23.6% of the sample of children and adolescents) and persistent rhinitis, using exclusively nasal corticosteroid, were not hospitalized, and there was a decrease of 84.2% in the frequency of emergency room visits during monitoring in the ProAR-FS. Scientific evidence suggests that treatment of rhinitis with topical nasal corticosteroids prevents bronchial hyperresponsiveness associated with the exposure to allergens and can avoid the exacerbations of symptoms in patients with mild asthma.…”

Paediatric rhinitis: position paper of the European Academy of Allergy and Clinical Immunology

“…Allergic rhinitis also increases the risk of asthma hospitalization. In a cross-sectional study involving 126 asthmatic children and adolescents, the prevalence of AR was high and in combination with asthma severity constituted the major risk factor for emergency care attendance (43). Viral upper respiratory tract infection together with allergic sensitization and allergen exposure has been demonstrated to synergistically increase the risk of emergency care with asthma (44).…”

Cephalometric Evaluation of Children with Allergic Rhinitis and Mouth Breathing

“…1 It is rarely observed as an isolated pathology, often being associated with asthma, [2][3][4][5] sinusitis, lymphoid tissue hypertrophy and obstructive sleep apnea. [2][3] There is a prevalence of 75 to 80% of asthma in patients who have allergic rhinitis.…”

“…[2][3] There is a prevalence of 75 to 80% of asthma in patients who have allergic rhinitis. 5 Many of these patients also display mouth breathing. Rhinitis prevalence increases with age, 4,6 presenting wide variable values between countries and studies.…”