BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory disorder associated with asthma. This association is well described in patients with CRSwNP undergoing endoscopic sinus surgery (ESS); however, some patients are never referred for surgery, and the frequency of asthma in this group is largely unknown. OBJECTIVE: To determine the frequency of asthma in patients with CRSwNP treated in a primary care (PC) setting who have never been referred for surgery and to compare this with ESS patients. METHODS: Fifty-seven patients with CRSwNP who had never undergone ESS were prospectively recruited from nine PC ear, nose, and throat clinics in the Copenhagen area. CRSwNP was diagnosed according to the European Position Paper on Chronic Rhinosinusitis and Nasal Polyps; severity was assessed by using a visual analog scale. Allergy, lung function, and asthma tests (reversibility to β2-agonist, peak expiratory flow variability, and mannitol challenge) were performed. Findings were compared with our previously published data from patients with CRSwNP referred for surgery. RESULTS: Asthma was diagnosed in 25 patients (44%) based on respiratory symptoms and a positive asthma test; of these, 12 (48%) had undiagnosed asthma prior to study onset. Furthermore, when using the same methods, we found a lower frequency of asthma in PC patients compared with ESS patients (44% versus 65%, p = 0.04). CONCLUSION: A high prevalence of asthma in PC patients with CRSwNP was found. Frequently, asthma was undiagnosed. However, asthma was significantly less prevalent in PC patients compared with patients referred for ESS. The frequent concomitance of asthma, i.e., united airways disease, in PC patients calls for closer collaboration between ear, nose, and throat specialists, and asthma specialists.
BACKGROUND:Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory disorder associated with asthma. This association is well described in patients with CRSwNP undergoing endoscopic sinus surgery (ESS); however, some patients are never referred for surgery, and the frequency of asthma in this group is largely unknown. OBJECTIVE: To determine the frequency of asthma in patients with CRSwNP treated in a primary care (PC) setting who have never been referred for surgery and to compare this with ESSpatients. METHODS: Fifty-seven patients with CRSwNP who had never undergone ESS were prospectively recruited from nine PC ear, nose, and throat clinics in the Copenhagen area. CRSwNP was diagnosed according to the European Position Paper on Chronic Rhinosinusitis and Nasal Polyps; severity was assessed by using a visual analog scale. Allergy, lung function, and asthma tests (reversibility to β2-agonist, peak expiratory flow variability, and mannitol challenge) were performed. Findings were compared with our previously published data from patients with CRSwNP referred for surgery. RESULTS:Asthma was diagnosed in 25 patients (44%) based on respiratory symptoms and a positive asthma test; of these, 12 (48%) had undiagnosed asthma prior to study onset. Furthermore, when using the same methods, we found a lower frequency of asthma in PC patients compared with ESSpatients (44% versus 65%, p = 0.04). CONCLUSION: A high prevalence of asthma in PC patients with CRSwNP was found. Frequently, asthma was undiagnosed. However, asthma was significantly less prevalent in PC patients compared with patients referred for ESS. The frequent concomitance of asthma, i.e., united airways disease, in PC patients calls for closer collaboration between ear, nose, and throat specialists, and asthma specialists.
Authors: Carl M Philpott; Sally Erskine; Claire Hopkins; Nirmal Kumar; Shahram Anari; Naveed Kara; Sankalp Sunkaraneni; Jaydip Ray; Allan Clark; Andrew Wilson; Sally Erskine; Carl Philpott; Allan Clark; Claire Hopkins; Alasdair Robertson; Shahzada Ahmed; Naveed Kara; Sean Carrie; Vishnu Sunkaraneni; Jaydip Ray; Shahram Anari; Paul Jervis; Jaan Panesaar; Amir Farboud; Nirmal Kumar; Russell Cathcart; Robert Almeyda; Hisham Khalil; Peter Prinsley; Nicolas Mansell; Mahmoud Salam; Jonathan Hobson; Jane Woods; Emma Coombes Journal: Respir Res Date: 2018-06-27
Authors: Filip Raciborski; Magdalena Arcimowicz; Bolesław Samoliñski; Wojciech Pinkas; Piotr Samel-Kowalik; Andrzej Śliwczyñski Journal: Postepy Dermatol Alergol Date: 2020-10-13 Impact factor: 1.837
Authors: Meryem Lahjaouj; Mohammed Laachoubi; Khadija El Bouhmadi; Youssef Oukessou; Sami Rouadi; Reda Abada; Mohammed Roubal; Mohammed Mahtar Journal: Ann Med Surg (Lond) Date: 2021-05-14