title: Temporal relationship of allergic rhinitis with asthma and other co-morbidities in a Mediterranean country: a retrospective study in a tertiary reference allergy clinic.
abstract: BACKGROUND
  Allergic rhinitis is a global health problem which causes major illness and represents a risk factor for asthma. The primary aim of the study was to record the clinical pattern of allergic rhinitis and its temporal relation with asthma in a Greek population.
  
  
  METHODS
  Three-hundred and sixteen subjects with documented diagnosis of allergic rhinitis in a two-year period were included in this study. All participants completed a standardised questionnaire with full retrospective epidemiological data for rhinitis; in addition, serum IgE measurement and skin prick tests with 22 common inhalant allergens were carried out, while spirometry was performed in subjects with self-reported or doctor-diagnosed asthma. All subjects with at least one positive skin test were included in study analysis.
  
  
  RESULTS
  One-hundred and sixty five out of 316 patients (49.1%) stated self reported-asthma while in 63/316 (19.9%) asthma was documented with spirometry. One hundred out of 165 (60.6%) had rhinitis as first clinical manifestation while in 24/165 (14.5%) asthma symptoms appeared first; the remaining 31/165 (24.9%) reported simultaneous onset of upper and lower airways' symptoms. About 68.5% were sensitised to seasonal allergens exclusively, while 50% were sensitised to ≥ 1 of Parietaria, grasses sp., Olea eur. The duration of rhinitis in the subpopulation of patients with self-reported asthma (n=165) was significantly higher compared with non-asthmatics (mean=3.22 years, p<0.001). Survival analysis for the estimation of asthma onset showed that the mean time interval with rhinitis only is 16.6 years (median 12 years, incidence 0.0596).
  
  
  CONCLUSIONS
  The unique environmental conditions and the aerobiology of each area clearly affect the clinical features of respiratory allergy.
authors.affiliation: Allergy Clinical Research Center, Allergy Unit, Attikon University Hospital, Medical School, University of Athens, Athens, Greece. mmakris.allergy@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Makris
authors.forename: S
authors.initials: S
authors.lastname: Koulouris
authors.forename: I
authors.initials: I
authors.lastname: Koti
authors.forename: X
authors.initials: X
authors.lastname: Aggelides
authors.forename: K
authors.initials: K
authors.lastname: Sideri
authors.forename: C
authors.initials: C
authors.lastname: Chliva
authors.forename: E
authors.initials: E
authors.lastname: Vassilatou
authors.forename: D
authors.initials: D
authors.lastname: Kalogeromitros
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology*; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006115:Greece; D006801:Humans; D015994:Incidence; D008297:Male; D019083:Mediterranean Region; D032403:Parietaria; D011058:Pollen / Q000276:immunology*; D012189:Retrospective Studies; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012882:Skin Tests; D013147:Spirometry
chemical_list: D000485:Allergens