Screening spirometry to detect respiratory allergy.
BACKGROUND
Recently, it has been evidenced that the forced expiratory flow at the 25 and 75% of the pulmonary volume (FEF25-75) might be considered as a possible marker of early bronchial impairment in patients with allergic rhinitis alone.


OBJECTIVE
The aim of this study was to determine whether a spirometric impairment may predict allergy during screening visit.


METHODS
The study included 283 Navy soldiers (255 males, mean age 27.1 + 8.2) who had to undergo spirometry for attending specific courses. Fifty-four showed slight spirometric anomalies. Thus, they referred to Navy Hospital of La Spezia for standardized tests: skin prick test, spirometry, and methacholine bronchial challenge.


RESULTS
Forty seven (87%) subjects were sensitized (47% monosensitized and 53% polysensitized). Allergic rhinitis was diagnosed in 25 subjects with median nasal TSS 5. FVC and FEV1 values were normal, whereas FEF25-75 values were reduced (61.8 + 14.8 % of predicted), bronchodilation test was significant for FEF25-75 (82.9 + 16.8% of predicted; p<0.001) only. Bronchial hyperreactivity (BHR) was detected in 28 subjects, all but 1 were sensitized.


CONCLUSIONS
This study provides evidence, relevant to clinical care, that mild spirometric impairment may generate the suspect of allergic disorders, thus spirometry could be more frequently performed in general population screening.
Cirillo
I
I
Ospedale Marina Militare, La Spezia, Italy.
Klersy
C
C
Marseglia
G
G
Tosca
M
M
Ciprandi
G
G
D000328:Adult; D001985:Bronchial Provocation Tests; D016085:Bronchoconstrictor Agents; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008450:Maximal Midexpiratory Flow Rate; D016210:Methacholine Chloride; D008889:Military Personnel; D011237:Predictive Value of Tests; D012130:Respiratory Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D012720:Severity of Illness Index; D012882:Skin Tests; D013147:Spirometry; D014797:Vital Capacity
D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride