Registration successful
Account activated – pending validation.
Your account has been activated successfully, but we still need to validate you as a healthcare professional. We’ll send you an email with the result of the validation process in the next three days.
In the meantime, you can enjoy access to all the latest news, events and resources for different therapy areas on our website.Highlights from the American Academy of Allergy, Asthma & Immunology Annual Meeting, March 2016
The 2016 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) was held in Los Angeles, California, between 4–7 March.1
Highlights of this year’s meeting included: clinical and epidemiological differences between acute and chronic urticaria in childhood; vitamin D levels and the prevalence and development of allergic rhinitis: a systematic review and meta-analysis; accuracy of allergic rhinitis diagnosis using clinical criteria and assessments of the quality of life in patients with chronic urticaria.
Urticaria in childhood – clinical and epidemiological differences between acute and chronic urticaria
Mehap Haktanir Abdul presented a prospective study which investigated aetiologic differences in children with urticaria. 2Their study included children between 4 months and 17 years of age (n=182) who were referred to the author’s clinic for urticaria evaluation. Serologic, autoimmune and allergic assessments were performed.2 Acute urticaria was diagnosed in 58.2% of children (n=106), and chronic urticaria in 41.8% (n=76). 2
Children with chronic urticaria more frequently had physical urticaria (48.7%) than those with acute urticaria. 2
Patients with acute urticaria had higher levels of C-reactive protein, eosinophils, IgE, and complement C3 and C4 compared with those with chronic urticaria, but this was not statistically significant. 2
Children with acute urticaria were also more likely to experience spontaneous resolution than children with chronic urticaria (p=0.016). 2
Based on these observed clinical and epidemiological differences, the authors suggested that children with chronic urticaria should be evaluated for physical urticaria. 2
Vitamin D levels and the prevalence and development of allergic rhinitis- a systematic review and meta-analysis
Vitamin D has been found to influence the immune system and may thereby play an important role in allergic disease. 3Yoon Hee Kim and colleagues carried out a systematic review and meta-analysis of the current literature, which found little evidence that 25(OH)D levels were related to the prevalence or the development of allergic rhinitis (AR). 3
Ten cross-sectional and 6 prospective studies which investigated the prevalence and development of AR, respectively, were identified during a literature search up to 28 February 2015. 3The cross-sectional studies investigated current levels of 25(OH)D and the prevalence of current AR. The prospective studies related previous 25(OH)D levels to the development of AR. 3
Meta-analysis for top versus bottom category of 25(OH)D levels revealed pooled odds ratios of 0.95 [0.76–1.20] (n=42,925) for the 10 cross-sectional studies and 0.89 [0.70–1.15] (n=22,184) for the 6 prospective studies. 3
The authors concluded that based on their findings, the prevalence and development of AR may not be related to 25(OH)D levels. 3However, the authors acknowledged that the studies included in the analysis were heterogeneous and of a retrospective and observational design, and therefore large randomised controlled trials are required to ascertain whether vitamin D supplementation could prevent AR. 3
Accuracy of allergic rhinitis diagnosis using clinical criteria
Ashish Mathur presented a study investigating the sensitivity and specificity of an allergic rhinitis (AR) diagnosis based on clinical criteria (history and a physical) in identifying skin prick test (SPT)-positive rhinitis. 4The study enrolled children (aged 6–11 years) from the non-selected Tucson Children’s Respiratory Study birth cohort. 4SPTs were performed at 6 and 11 years of age. 4Atopy and atopic rhinitis were defined by SPT, active rhinitis was defined by questionnaire and allergic rhinitis was defined by caregiver report of a physician diagnosis.
Of the children with active rhinitis at age 6 (n=320), 52% had atopic rhinitis. Of these, 86% were correctly diagnosed as having allergic rhinitis by a physician (n=143/167).4 However, only 20% of children with non-atopic rhinitis (no positive SPT; n=153) were correctly diagnosed as non-allergic. 4
At age 6, 80% of children with non-allergic rhinitis (n=153) were correctly identified as allergic by physicians. 4
Similarly, at 11 years old, physician-diagnosed allergic rhinitis was correct in 92% of children with atopic rhinitis, but children with non-atopic rhinitis were correctly identified as non-allergic by physicians in only 12% of cases. 4
The authors concluded that allergic rhinitis was overdiagnosed by physicians using clinical criteria of nasal symptoms. They suggest accurate diagnosis should involve objective measurements of specific IgE. 4
Assessments of quality of life in patients with chronic urticaria
Kelly Yoshimi Kanamori presented results of a cross-sectional study that investigated the effect of chronic urticaria on patient’s quality of life (QoL) using a specific Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL). 5The CU-Q2oL includes 23 questions that are scored on a scale from 1–5 (1 being no complaints and 5 being many complaints, with poor quality of life defined as scores ≥3). 5
The study included 61 patients with chronic urticaria (95% female) with a mean age of 41 years in a tertiary hospital. 5
Patients who required medications beyond antihistamines had higher average questionnaire scores than patients who responded to antihistamines (72.4 versus 57.2). 5
In addition, a greater proportion of patients who required medications beyond antihistamines had a longer duration of disease, compared with patients who responded to antihistamines (56% ≥10 years, versus 37%). 5
Issues relating to social relationships, diet and medicinal side effects were regarded as having the most important impact on QoL. 5
The authors concluded that patients with treatment-resistant chronic urticaria who required medications beyond antihistamines had chronic urticaria for longer periods of time, and with greater negative effects on QoL. 5
Reference list
- 2016 AAAAI Annual Meeting Final Programme. [Online] 2016.
- Haktanir Abdul M, Orhan F, Kilic Topcu IK, Karakas T, Baki A. Clinical and epidemiological differences in patients with acute urticaria and chronic urticaria. Abstract 186 presented at AAAAI 2016. J Allergy Clin Immunol 2016; 137(2 Suppl): AB58.
- Hee Kim Y, Jung Kim M, Suk Sol I, Hee Yoon S, Park YA, Won Kim K, et al. Vitamin D level in allergic rhinitis: a systematic review and meta-analysis. Abstract 308 presented at AAAAI 2016. J Allergy Clin Immunol 2016; 137(2 Suppl): AB94.
- Mathur AK, Stern DA, Daines MO, Wright AL, Martinez FD, Carr TF. Sensitivity and specificity of a clinical diagnosis of allergic rhinitis in childhood. Abstract 533 presented at AAAAI 2016. J Allergy Clin Immunol 2016; 137(2 Suppl): AB163.
- Yoshimi Kanamori K, Tavares Alcantara C, Abílio Motta A, Kalil J, Agondi RC. Quality of life assessment in patients with chronic urticaria. Abstract 842 presented at AAAAI 2016. J Allergy Clin Immunol 2016; 137(2 Suppl): AB258.
