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SELECTED ARTICLES FROM THE RECENT LITERATURE 2007
August 22, 2007
Spirometry in children with allergic rhinitis
Summary
Background - The "one airway" concept is based on evidence that a similar pattern of allergic inflammation can exist in the upper and lower airways. But is pulmonary function decreased in children with allergic rhinitis but no clinical signs of asthma?
Findings - Kesiel et al of the Bnai Zion Medical Center in Haifa, Israel evaluated pulmonary function in 50 children with moderate to severe allergic rhinitis (AR) due to mite sensitization but no history of asthmatic manifestations.
They found that the FEF 25-75 values were less than 80% of predicted in 11 of the 50 children with AR but only one of 26 age-matched healthy controls. Reversibility of this decreased FEF 25-75 following beta agonist inhalation occurred in 9 of the 11. Within 3 months of subsequent nasal corticosteroid therapy, the FEF25-75 had increased to >80% of predicted in 7 of 10 of the children with initially low FEF 25-75 levels.
Reference
Pediatr Allergy Immunol 2007; July 25, E pub
Editor's Comments
The authors of this report concluded that abnormal pulmonary function occurs in a sizable percentage of those with AR but not asthma. The reversible obstruction remits after treatment with nasal corticosteroids. However, the FEV-1, a more stable measure of airway obstruction in asthma, was not impressively decreased in these children with AR. The FEF 25-75 is a very sensitive measure, subject to considerable spontaneous variation in sequential measurements. Thus a reversible obstruction of airflow through the smaller lower airways may occur in AR but further investigation is needed to be sure of this.
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