Document Detail

Risk factors for allergic rhinitis in Costa Rican children with asthma.
MedLine Citation:
PMID:  19796208     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Risk factors for allergic rhinitis (AR) in asthmatics are likely distinct from those for AR or asthma alone. We sought to identify clinical and environmental risk factors for AR in children with asthma.
METHODS: We performed a cross-sectional study of 616 Costa Rican children aged 6-14 years with asthma. Candidate risk factors were drawn from questionnaire data, spirometry, methacholine challenge testing, skin testing, and serology. Two outcome measures, skin test reaction (STR)-positive AR and physician-diagnosed AR, were examined by logistic regression.
RESULTS: STR-positive AR had high prevalence (80%) in Costa Rican children with asthma, and its independent risk factors were nasal symptoms after exposure to dust or mold, parental history of AR, older age at asthma onset, oral steroid use in the past year, eosinophilia, and positive IgEs to dust mite and cockroach. Physician-diagnosed AR had lower prevalence (27%), and its independent risk factors were nasal symptoms after pollen exposure, STR to tree pollens, a parental history of AR, inhaled steroid and short-acting beta2 agonist use in the past year, household mold/mildew, and fewer older siblings. A physician's diagnosis was only 29.5% sensitive for STR-positive AR.
CONCLUSIONS: Risk factors for AR in children with asthma depend on the definition of AR. Indoor allergens drive risk for STR-positive AR. Outdoor allergens and home environmental conditions are risk factors for physician-diagnosed AR. We propose that children with asthma in Costa Rica and other Latin American nations undergo limited skin testing or specific IgE measurements to reduce the current under-diagnosis of AR.
S Bunyavanich; M E Soto-Quiros; L Avila; D Laskey; J M Senter; J C Celedón
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-10-01
Journal Detail:
Title:  Allergy     Volume:  65     ISSN:  1398-9995     ISO Abbreviation:  Allergy     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-18     Completed Date:  2010-03-02     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  7804028     Medline TA:  Allergy     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  256-63     Citation Subset:  IM    
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MeSH Terms
Asthma / complications,  epidemiology*,  immunology
Costa Rica / epidemiology
Cross-Sectional Studies
Hypersensitivity / complications,  epidemiology*,  immunology
Rhinitis / complications,  epidemiology*,  immunology
Skin Tests
Grant Support
HL04370/HL/NHLBI NIH HHS; HL066289/HL/NHLBI NIH HHS; K01 HL004370/HL/NHLBI NIH HHS; K01 HL004370-01A1/HL/NHLBI NIH HHS; K01 HL004370-02/HL/NHLBI NIH HHS; K01 HL004370-03/HL/NHLBI NIH HHS; K01 HL004370-04/HL/NHLBI NIH HHS; K01 HL004370-05/HL/NHLBI NIH HHS; R01 HL066289/HL/NHLBI NIH HHS; R01 HL066289-01/HL/NHLBI NIH HHS; R01 HL066289-02/HL/NHLBI NIH HHS; R01 HL066289-03/HL/NHLBI NIH HHS; R01 HL066289-04/HL/NHLBI NIH HHS; R01 HL066289-05/HL/NHLBI NIH HHS; R37 HL066289/HL/NHLBI NIH HHS; R37 HL066289-06/HL/NHLBI NIH HHS; R37 HL066289-07/HL/NHLBI NIH HHS; R37 HL066289-08/HL/NHLBI NIH HHS; T32 HL007427/HL/NHLBI NIH HHS; T32 HL007427/HL/NHLBI NIH HHS; T32 HL007427-28/HL/NHLBI NIH HHS; T32 HL007427-29/HL/NHLBI NIH HHS

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