Aeroallergen Sensitivity Pattern in Poorly Controlled Asthmatics and its Relation to Asthma Control in a Tertiary Care Setting of Central Kerala, India OC22-OC25
Dr. Divya Ramachandran,
Consultant Pulmonologist, Rajagiri Hospital, Aluva, Chunangamveli, Kochi-683112, Kerala, India.
Introduction: Nasobronchial allergy is an exceedingly common problem in clinical practice. Estimates reveal that the prevalence of nasobronchial allergy is increasing worldwide, including in India. Sensitivity to individual aeroallergens varies depending on geography, genetic and environmental factors.
Aim: To identify the sensitivity pattern to common aeroallergens in poorly controlled asthma patients and to correlate asthma severity with sensitivity to specific aeroallergens.
Materials and Methods: A prospective cross-sectional study was conducted on out-patients attending the Department of Pulmonary Medicine with a diagnosis of asthma as per GINA guidelines. Patients above seven years with features of asthma were included in the study. The Asthma severity was assessed using the Asthma Control Test (ACT) questionnaire and lung function studies. SPT was performed as per clinical indication. The skin allergy sensitivity patterns were compared in groups as per their disease severity and level of control using Chi-square and Spearman rank correlation.
Results: Patients with features of inadequately controlled asthma (ACT score less than 20 and FEV1 less than 80% predicted) showed a higher occurrence of positive reaction in the SPT to multiple aero and food allergens as compared with those having good ACT score and FEV1 >80%.
Conclusion: Allergen sensitivity is very common in asthma. House dust mite, fungal allergens and grass pollens were the common allergen sensitisation identified in subjects with poorly controlled asthma. A correlation was seen between inadequately controlled asthma and sensitisation to multiple aeroallergens. So, vigorous allergen screening and allergen immunotherapy must be included in the management protocol of asthma.