The role of allergy in manifestations of respiratory disease in adult cystic fibrosis.
BACKGROUND
Variability is present in the expression of the clinical phenotype in cystic fibrosis (CF). Part of this variability may be explained by the coexistence of allergy in CF.


OBJECTIVE
To determine the rate of allergy in adult CF and evaluate the association between allergy and the manifestations of upper and lower airway disease.


METHODS
We performed a cross-sectional study of consecutive patients enrolled in a university hospital adult CF clinic. Allergen specific IgE was determined by radioallergosorbent and skin prick tests to common aeroallergens. We characterized features of upper and lower airway disease by clinical evaluation of rhinitis and spirometry before allergy testing.


RESULTS
The study population consisted of 55 patients. Allergen specific IgE was present to at least 1 aeroallergen in 67% by skin prick testing and 80% by radioallergosorbent testing. Rhinitis occurred in 50% of the population and was associated with immediate-type hypersensitivity to aeroallergens other than molds. The frequency of rhinitis increased when there was sensitization to a greater number of aeroallergens and rarely occurred in the absence of allergic sensitization. There was no detectable difference in lung function between those with and without allergic sensitization.


CONCLUSIONS
Immediate-type hypersensitivity to aeroallergens commonly occurs in adult CF. The coexistence of allergy in CF is associated with clinical features of rhinitis. Because allergic manifestations of CF warrant appropriate therapy, individuals with CF should be evaluated for coexistent allergy.
Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington 98195-6522, USA. tealh@u.washington.edu
Teal S
TS
Hallstrand
Emanuel
E
Calenoff
Jonathan W
JW
Becker
William R
WR
Henderson
Moira L
ML
Aitken
D000328:Adult; D000485:Allergens / Q000276:immunology*; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000150:complications* / Q000276:immunology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006967:Hypersensitivity / Q000150:complications* / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D011852:Radioallergosorbent Test; D012130:Respiratory Hypersensitivity / Q000150:complications* / Q000276:immunology; D012220:Rhinitis / Q000150:complications* / Q000276:immunology; D012882:Skin Tests
D000485:Allergens; D007073:Immunoglobulin E