BACKGROUND: Allergic rhinitis (AR) symptom phenotypes have been described, and two different classifications exist. The former classification, seasonal versus perennial AR (SAR-PAR), and the Allergic Rhinitis and Its Impact on Asthma (ARIA) classifications, intermittent (INT) versus persistent (PER; ≥4 days/wk and ≥4 consecutive weeks) and mild versus moderate/severe. ARIA cataloging of INT-PER is based on the patient's description of the frequency of symptoms. This study was designed to (1) describe the epidemiology of these two AR classifications and relate them to one another and to a visual analog severity scale (VAS) and (2) describe how the cataloging of these classifications differs between patients and allergists. METHODS: Skin-prick test-positive AR patients seen nationwide by Mexican allergists completed a validated questionnaire cataloging AR. They recorded demographic data and AR severity on a VAS. The patients' physicians were also asked to classify the AR phenotypes. RESULTS: Of the patients, 56.5% had INT and 82.2% had PAR and moderate-severe (84.7%) AR. However, 57% of the INT-PAR patients were misdiagnosed as PER-PAR by their physicians. PER patients had more severe disease with a longer clinical history, more PAR, nose and eye symptoms, and a higher VAS score, and only 7% had mild symptoms. VAS values ≥7.45 relate to PER (sensitivity, 68%; specificity, 65%). VAS ≤6.2 indicated mild and ≥6.4 indicated moderate-severe AR. Similar to the adults, in the 2- to 11 year and 12- to 17-year age groups perennial, INT, and moderate-severe AR was the most frequent finding, but the children had more INT (p < 0.01) and mild (p < 0.03) symptoms, less SAR (p = 0.03), and more physician-diagnosed asthma (p < 0.05). Public health care (PHC) patients had more INT (p = 0.016). CONCLUSION: In the PAR group, the physicians' classification of INT-PER often goes astray. PER overdiagnoses might affect treatment decisions because PER is a more severe phenotype. VAS is useful to evaluate severity. In Mexican AR patients, rhinitis symptom phenotypes differ according to age and between private and PHC system patients.
BACKGROUND:Allergic rhinitis (AR) symptom phenotypes have been described, and two different classifications exist. The former classification, seasonal versus perennial AR (SAR-PAR), and the Allergic Rhinitis and Its Impact on Asthma (ARIA) classifications, intermittent (INT) versus persistent (PER; ≥4 days/wk and ≥4 consecutive weeks) and mild versus moderate/severe. ARIA cataloging of INT-PER is based on the patient's description of the frequency of symptoms. This study was designed to (1) describe the epidemiology of these two AR classifications and relate them to one another and to a visual analog severity scale (VAS) and (2) describe how the cataloging of these classifications differs between patients and allergists. METHODS: Skin-prick test-positive AR patients seen nationwide by Mexican allergists completed a validated questionnaire cataloging AR. They recorded demographic data and AR severity on a VAS. The patients' physicians were also asked to classify the AR phenotypes. RESULTS: Of the patients, 56.5% had INT and 82.2% had PAR and moderate-severe (84.7%) AR. However, 57% of the INT-PAR patients were misdiagnosed as PER-PAR by their physicians. PER patients had more severe disease with a longer clinical history, more PAR, nose and eye symptoms, and a higher VAS score, and only 7% had mild symptoms. VAS values ≥7.45 relate to PER (sensitivity, 68%; specificity, 65%). VAS ≤6.2 indicated mild and ≥6.4 indicated moderate-severe AR. Similar to the adults, in the 2- to 11 year and 12- to 17-year age groups perennial, INT, and moderate-severe AR was the most frequent finding, but the children had more INT (p < 0.01) and mild (p < 0.03) symptoms, less SAR (p = 0.03), and more physician-diagnosed asthma (p < 0.05). Public health care (PHC) patients had more INT (p = 0.016). CONCLUSION: In the PAR group, the physicians' classification of INT-PER often goes astray. PER overdiagnoses might affect treatment decisions because PER is a more severe phenotype. VAS is useful to evaluate severity. In Mexican AR patients, rhinitis symptom phenotypes differ according to age and between private and PHC systempatients.
Authors: Diana A Morillo-Argudo; Dolores S Andrade Tenesaca; Claudia R Rodas-Espinoza; Michael R Perkin; Tesfalem Lukas Gebreegziabher; Gabriela A Zuñiga; Diana D Andrade Muñoz; Patricia L Ramírez; Ana A García García; Angélica M Ochoa-Avilés Journal: World Allergy Organ J Date: 2020-11-13 Impact factor: 4.084
Authors: J Bousquet; P W Hellings; I Agache; A Bedbrook; C Bachert; K C Bergmann; M Bewick; C Bindslev-Jensen; S Bosnic-Anticevitch; C Bucca; D P Caimmi; P A M Camargos; G W Canonica; T Casale; N H Chavannes; A A Cruz; G De Carlo; R Dahl; P Demoly; P Devillier; J Fonseca; W J Fokkens; N A Guldemond; T Haahtela; M Illario; J Just; T Keil; L Klimek; P Kuna; D Larenas-Linnemann; M Morais-Almeida; J Mullol; R Murray; R Naclerio; R E O'Hehir; N G Papadopoulos; R Pawankar; P Potter; D Ryan; B Samolinski; H J Schunemann; A Sheikh; F E R Simons; C Stellato; A Todo-Bom; P V Tomazic; A Valiulis; E Valovirta; M T Ventura; M Wickman; I Young; A Yorgancioglu; T Zuberbier; W Aberer; C A Akdis; M Akdis; I Annesi-Maesano; J Ankri; I J Ansotegui; J M Anto; S Arnavielhe; A Asarnoj; H Arshad; F Avolio; I Baiardini; C Barbara; M Barbagallo; E D Bateman; B Beghé; E H Bel; K S Bennoor; M Benson; A Z Białoszewski; T Bieber; L Bjermer; H Blain; F Blasi; A L Boner; M Bonini; S Bonini; I Bosse; J Bouchard; L P Boulet; R Bourret; P J Bousquet; F Braido; A H Briggs; C E Brightling; J Brozek; R Buhl; C Bunu; E Burte; A Bush; F Caballero-Fonseca; M A Calderon; T Camuzat; V Cardona; P Carreiro-Martins; A M Carriazo; K H Carlsen; W Carr; A M Cepeda Sarabia; M Cesari; L Chatzi; R Chiron; T Chivato; E Chkhartishvili; A G Chuchalin; K F Chung; G Ciprandi; J Correia de Sousa; L Cox; G Crooks; A Custovic; S E Dahlen; U Darsow; T Dedeu; D Deleanu; J A Denburg; G De Vries; A Didier; A T Dinh-Xuan; D Dokic; H Douagui; G Dray; R Dubakiene; S R Durham; G Du Toit; M S Dykewicz; P Eklund; Y El-Gamal; E Ellers; R Emuzyte; J Farrell; A Fink Wagner; A Fiocchi; M Fletcher; F Forastiere; M Gaga; A Gamkrelidze; B Gemicioğlu; J E Gereda; R Gerth van Wick; S González Diaz; I Grisle; L Grouse; Z Gutter; M A Guzmán; B Hellquist-Dahl; J Heinrich; F Horak; J O' B Hourihane; M Humbert; M Hyland; G Iaccarino; E J Jares; C Jeandel; S L Johnston; G Joos; O Jonquet; K S Jung; M Jutel; I Kaidashev; M Khaitov; O Kalayci; A F Kalyoncu; P Kardas; P K Keith; M Kerkhof; H A M Kerstjens; N Khaltaev; M Kogevinas; V Kolek; G H Koppelman; M L Kowalski; M Kuitunen; I Kull; V Kvedariene; B Lambrecht; S Lau; D Laune; L T T Le; P Lieberman; B Lipworth; J Li; K C Lodrup Carlsen; R Louis; C Lupinek; W MacNee; Y Magar; A Magnan; B Mahboub; D Maier; I Majer; J Malva; P Manning; E De Manuel Keenoy; G D Marshall; M R Masjedi; E Mathieu-Dupas; M Maurer; S Mavale-Manuel; E Melén; E Melo-Gomes; E O Meltzer; J Mercier; H Merk; N Miculinic; F Mihaltan; B Milenkovic; J Millot-Keurinck; Y Mohammad; I Momas; R Mösges; A Muraro; L Namazova-Baranova; R Nadif; H Neffen; K Nekam; A Nieto; B Niggemann; L Nogueira-Silva; M Nogues; T D Nyembue; K Ohta; Y Okamoto; K Okubo; M Olive-Elias; S Ouedraogo; P Paggiaro; I Pali-Schöll; S Palkonen; P Panzner; A Papi; H S Park; G Passalacqua; S Pedersen; A M Pereira; O Pfaar; R Picard; B Pigearias; I Pin; D Plavec; W Pohl; T A Popov; F Portejoie; D Postma; L K Poulsen; D Price; K F Rabe; F Raciborski; G Roberts; C Robalo-Cordeiro; F Rodenas; L Rodriguez-Mañas; C Rolland; M Roman Rodriguez; A Romano; J Rosado-Pinto; N Rosario; M Rottem; M Sanchez-Borges; J Sastre-Dominguez; G K Scadding; N Scichilone; P Schmid-Grendelmeier; E Serrano; M Shields; V Siroux; J C Sisul; I Skrindo; H A Smit; D Solé; T Sooronbaev; O Spranger; R Stelmach; P J Sterk; T Strandberg; J Sunyer; C Thijs; M Triggiani; R Valenta; A Valero; M van Eerd; E van Ganse; M van Hague; O Vandenplas; L L Varona; B Vellas; G Vezzani; T Vazankari; G Viegi; T Vontetsianos; M Wagenmann; S Walker; D Y Wang; U Wahn; T Werfel; B Whalley; D M Williams; S Williams; N Wilson; J Wright; B P Yawn; P K Yiallouros; O M Yusuf; A Zaidi; H J Zar; M E Zernotti; L Zhang; N Zhong; M Zidarn Journal: Clin Transl Allergy Date: 2016-12-30 Impact factor: 5.871
Authors: Ludger Klimek; Karl-Christian Bergmann; Tilo Biedermann; Jean Bousquet; Peter Hellings; Kirsten Jung; Hans Merk; Heidi Olze; Wolfgang Schlenter; Philippe Stock; Johannes Ring; Martin Wagenmann; Wolfgang Wehrmann; Ralph Mösges; Oliver Pfaar Journal: Allergo J Int Date: 2017-01-19
Authors: Tihomir B Mustakov; Todor A Popov; Tanya Z Kralimarkova; Maria T Staevska; Vasil D Dimitrov Journal: World Allergy Organ J Date: 2016-04-04 Impact factor: 4.084