Pub Date : 2021-01-01DOI: 10.4103/ijaai.ijaai_44_20
Sudhir Kumar, D. Rai, Subhash Kumar
The combination of allergic bronchopulmonary aspergillosis (ABPA) and eosinophilic granulomatosis with polyangiitis (EGPA) or Grnaulomatosis polyangitis (GPA) has been well described in the literature, but this is the first case report of ABPA with allergic fungal rhinosinusitis (AFRS) mimicking as granulomatous vasculitis (EGPA and GPA) as per the authors. A 25-year-old woman, symptomatic for the past 4 years and initially treated for bronchial asthma, presented with worsening dyspnea, cough, fever, anorexia, and leg pain. There were increasing pulmonary opacities in the chest radiograph, and a computed tomography scan demonstrated left hilar adenopathy and consolidation. The patient was diagnosed with ABPA after the initial workup and prescribed oral prednisolone with itraconazole. The patient also had nasal polyposis, sinusitis, mucin in sinuses, and fungal growth in mucin favoring the diagnosis of AFRS. Fiberoptic bronchoscopy showed plaque-like endobronchial lesions and bronchial stenosis, and histopathologic examination of the biopsy from the nodular lesion demonstrated eosinophilic bronchitis. Normal serum angiotensin-converting enzyme levels, positive Mantoux test, and the eosinophilic inflammation in the endobronchial biopsy ruled out the possibility of sarcoidosis. Both cytoplasmic and perinuclear antineutrophil cytoplasmic antibodies (c- and p-ANCA, respectively) were found positive in a vasculitis panel test, the positive p-ANCA favoring the diagnosis of EGPA, while the combination of endobronchial lesion, sinus abnormality, and nonresolving consolidation along with positive c-ANCA favoring the diagnosis of GPA as well. However, in the absence of histopathological evidence of vasculitis, ANCA may be false positive. Accordingly, a final diagnosis of ABPA combined with AFRS was made. The patient responded well to oral prednisolone along with inhaled asthma medications. Our case highlights the overlapping clinical features of eosinophilic lung diseases and small-vessel vasculitis, which may coexist, and the need to investigate thoroughly for better clinical outcomes.
{"title":"A rare case of allergic bronchopulmonary aspergillosis with allergic fungal rhinosinusitis masquerading as granulomatous vasculitis","authors":"Sudhir Kumar, D. Rai, Subhash Kumar","doi":"10.4103/ijaai.ijaai_44_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_44_20","url":null,"abstract":"The combination of allergic bronchopulmonary aspergillosis (ABPA) and eosinophilic granulomatosis with polyangiitis (EGPA) or Grnaulomatosis polyangitis (GPA) has been well described in the literature, but this is the first case report of ABPA with allergic fungal rhinosinusitis (AFRS) mimicking as granulomatous vasculitis (EGPA and GPA) as per the authors. A 25-year-old woman, symptomatic for the past 4 years and initially treated for bronchial asthma, presented with worsening dyspnea, cough, fever, anorexia, and leg pain. There were increasing pulmonary opacities in the chest radiograph, and a computed tomography scan demonstrated left hilar adenopathy and consolidation. The patient was diagnosed with ABPA after the initial workup and prescribed oral prednisolone with itraconazole. The patient also had nasal polyposis, sinusitis, mucin in sinuses, and fungal growth in mucin favoring the diagnosis of AFRS. Fiberoptic bronchoscopy showed plaque-like endobronchial lesions and bronchial stenosis, and histopathologic examination of the biopsy from the nodular lesion demonstrated eosinophilic bronchitis. Normal serum angiotensin-converting enzyme levels, positive Mantoux test, and the eosinophilic inflammation in the endobronchial biopsy ruled out the possibility of sarcoidosis. Both cytoplasmic and perinuclear antineutrophil cytoplasmic antibodies (c- and p-ANCA, respectively) were found positive in a vasculitis panel test, the positive p-ANCA favoring the diagnosis of EGPA, while the combination of endobronchial lesion, sinus abnormality, and nonresolving consolidation along with positive c-ANCA favoring the diagnosis of GPA as well. However, in the absence of histopathological evidence of vasculitis, ANCA may be false positive. Accordingly, a final diagnosis of ABPA combined with AFRS was made. The patient responded well to oral prednisolone along with inhaled asthma medications. Our case highlights the overlapping clinical features of eosinophilic lung diseases and small-vessel vasculitis, which may coexist, and the need to investigate thoroughly for better clinical outcomes.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"26 1","pages":"27 - 32"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80168600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/ijaai.ijaai_6_21
S. De
OBJECTIVE: The present study was aimed to evaluate the diagnostic accuracy of impedance parameters to detect airflow obstruction and the severity of airflow obstruction in adults. METHODS: The spirometry parameters (forced expiratory volume in 1 s [FEV1], forced vital capacity [FVC], FEV1/FVC, FVC3/FVC, and FEF25-75) and respiratory impedance parameters (R5, R19, R5-19, and X5) measured by forced oscillation technique of consecutive 299 adults (male: 186) were included in the present analysis. The Spearman correlation coefficient (ρ) was used to assess the correlations of impedance parameters with spirometry indices. The area under the curve (AUC) was used to assess respiratory impedance parameters' diagnostic accuracy. RESULTS: The mean age of the study population was 54.1 ± 12.3 years, and 99 individuals (33%) had airflow obstruction (FEV1/FVC < 0.70) in spirometry. All spirometry indices (% of predicted) showed a weak negative correlation with R5, R19, R5-19, and weak positive correlation with X5. The R5 >142% predicted and X5 >136% predicted had the maximum AUC (0.75) with a sensitivity of up to 56% and specificity up to 86% to identify airflow obstruction. The impedance parameters showed low concordance with the severity of airflow obstruction. CONCLUSION: Respiratory impedance parameters had insufficient sensitivity to diagnose airflow obstruction and the severity of obstruction in adults. Thus, impedance parameters cannot a substitute for spirometry in diagnosing obstructive lung function.
{"title":"Diagnostic accuracy of respiratory impedance parameters to detect airflow obstruction in adults","authors":"S. De","doi":"10.4103/ijaai.ijaai_6_21","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_6_21","url":null,"abstract":"OBJECTIVE: The present study was aimed to evaluate the diagnostic accuracy of impedance parameters to detect airflow obstruction and the severity of airflow obstruction in adults. METHODS: The spirometry parameters (forced expiratory volume in 1 s [FEV1], forced vital capacity [FVC], FEV1/FVC, FVC3/FVC, and FEF25-75) and respiratory impedance parameters (R5, R19, R5-19, and X5) measured by forced oscillation technique of consecutive 299 adults (male: 186) were included in the present analysis. The Spearman correlation coefficient (ρ) was used to assess the correlations of impedance parameters with spirometry indices. The area under the curve (AUC) was used to assess respiratory impedance parameters' diagnostic accuracy. RESULTS: The mean age of the study population was 54.1 ± 12.3 years, and 99 individuals (33%) had airflow obstruction (FEV1/FVC < 0.70) in spirometry. All spirometry indices (% of predicted) showed a weak negative correlation with R5, R19, R5-19, and weak positive correlation with X5. The R5 >142% predicted and X5 >136% predicted had the maximum AUC (0.75) with a sensitivity of up to 56% and specificity up to 86% to identify airflow obstruction. The impedance parameters showed low concordance with the severity of airflow obstruction. CONCLUSION: Respiratory impedance parameters had insufficient sensitivity to diagnose airflow obstruction and the severity of obstruction in adults. Thus, impedance parameters cannot a substitute for spirometry in diagnosing obstructive lung function.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"30 1","pages":"22 - 26"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74563403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/ijaai.ijaai_64_20
R. Prasad, S. M. Ahsan Kazmi, R. Kacker, N. Gupta
Bronchial asthma is an inflammatory disease of the airways, which may be worsened due to many extrinsic factors. The most common trigger is the continuous exposure to allergens, of which fungal agents are important factors. A new phenotype of asthma called severe asthma with fungal sensitization (SAFS) has been described. It is diagnosed by the presence of severe asthma, fungal sensitization, and absence of allergic bronchopulmonary aspergillosis. SAFS is more of a diagnosis of exclusion. Treatment of SAFS initially should be similar to that of severe asthma including humanized anti-IgE monoclonal antibody and other biologics. These patients usually do not have their symptoms relieved with conventional treatment of severe asthma, i.e. high-dose inhaled corticosteroids and long-acting bronchodilators. Prolonged use of oral corticosteroids and pulse high-dose intravenous corticosteroid is effective. There are some evidence implicating the role of antifungal agents including itraconazole, but its use as a specific therapy requires further studies.
{"title":"Severe asthma with fungal sensitization","authors":"R. Prasad, S. M. Ahsan Kazmi, R. Kacker, N. Gupta","doi":"10.4103/ijaai.ijaai_64_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_64_20","url":null,"abstract":"Bronchial asthma is an inflammatory disease of the airways, which may be worsened due to many extrinsic factors. The most common trigger is the continuous exposure to allergens, of which fungal agents are important factors. A new phenotype of asthma called severe asthma with fungal sensitization (SAFS) has been described. It is diagnosed by the presence of severe asthma, fungal sensitization, and absence of allergic bronchopulmonary aspergillosis. SAFS is more of a diagnosis of exclusion. Treatment of SAFS initially should be similar to that of severe asthma including humanized anti-IgE monoclonal antibody and other biologics. These patients usually do not have their symptoms relieved with conventional treatment of severe asthma, i.e. high-dose inhaled corticosteroids and long-acting bronchodilators. Prolonged use of oral corticosteroids and pulse high-dose intravenous corticosteroid is effective. There are some evidence implicating the role of antifungal agents including itraconazole, but its use as a specific therapy requires further studies.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"10 1","pages":"3 - 7"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85432199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/ijaai.ijaai_52_20
Suhail Rafiq, Sumiaya Kiran, M. Dar, Uroosa Shabir, Sanna Birjees, O. ashraf
Common variable immunodeficiency is characterized by decreased levels of immunoglobulins leading to repeated infections of chest, gastrointestinal tract, etc., Radiological findings and clinical suspicion could be helpful in diagnosing common variable immunodeficiency thereby decreasing mortality and morbidity associated with disease. We present radiological findings in a 20-year-old patient with laboratory findings supporting the diagnosis of common variable immunodeficiency.
{"title":"Imaging findings in common variable immunodeficiency","authors":"Suhail Rafiq, Sumiaya Kiran, M. Dar, Uroosa Shabir, Sanna Birjees, O. ashraf","doi":"10.4103/ijaai.ijaai_52_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_52_20","url":null,"abstract":"Common variable immunodeficiency is characterized by decreased levels of immunoglobulins leading to repeated infections of chest, gastrointestinal tract, etc., Radiological findings and clinical suspicion could be helpful in diagnosing common variable immunodeficiency thereby decreasing mortality and morbidity associated with disease. We present radiological findings in a 20-year-old patient with laboratory findings supporting the diagnosis of common variable immunodeficiency.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"52 1","pages":"33 - 36"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89013811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/ijaai.ijaai_36_20
B. Bathula, P. Bandela, P. Ravikumar, B. Duvvuri, Subba Polimati
BACKGROUND: The role of leukotriene receptor antagonist is well documented in the management of chronic asthma. However, the efficacy in acute asthma is not yet established. AIM AND OBJECTIVES: This study was designed to evaluate the clinical efficacy of oral montelukast as an add-on drug to the standard therapy of the acute attack of bronchial asthma. MATERIALS AND METHODS: A prospective, institutional-based, single-blinded, randomized control study was done. A total of 100 (aged between 18 and 60 years) participants diagnosed with acute exacerbations due to bronchial asthma were enrolled in the study. They were divided into study and control groups randomly. The study group patients were treated with 10 mg of montelukast once in a day for 4 weeks as an add-on drug, whereas the control group received only standard medication of acute bronchial asthma (as per Global Initiative for Asthma guidelines). All the participants were monitored at baseline to every week for a month. RESULTS: All the 100 participants were assessed finally without any dropouts. The baseline characteristics were noted similarly in both groups. The mean age was 35.46 + 13.17 years in the control and 37.86 + 14.43 years in the study group. Majority were males in both the groups. At the end of the 4 weeks of oral montelukast administration, there was improvement in forced expiratory volume in 1 s (FEV1) and peak expiratory flow rate at 2 weeks and 1 month. On many occasions, there was a strong improvement in FEV1 and other clinical parameters after continuous treatment with beta-2 agonists and parenteral corticosteroids for patients with acute asthma. Even though there was no improvement in FEV1/forced vital capacity ratio among both the groups at 2 weeks and 4 weeks, statistically significant improvement was seen between 2 weeks to 1 month on baseline parameters. CONCLUSION: Administration of oral montelukast 10 mg as an add-on drug to standard therapy may help in quick recovery from acute bronchial asthma and relapse.
{"title":"Effect of leukotriene receptor antagonist therapy in bronchial asthma – A prospective, preliminary, hospital-based, randomized study in rural Konaseema, Andhra Pradesh","authors":"B. Bathula, P. Bandela, P. Ravikumar, B. Duvvuri, Subba Polimati","doi":"10.4103/ijaai.ijaai_36_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_36_20","url":null,"abstract":"BACKGROUND: The role of leukotriene receptor antagonist is well documented in the management of chronic asthma. However, the efficacy in acute asthma is not yet established. AIM AND OBJECTIVES: This study was designed to evaluate the clinical efficacy of oral montelukast as an add-on drug to the standard therapy of the acute attack of bronchial asthma. MATERIALS AND METHODS: A prospective, institutional-based, single-blinded, randomized control study was done. A total of 100 (aged between 18 and 60 years) participants diagnosed with acute exacerbations due to bronchial asthma were enrolled in the study. They were divided into study and control groups randomly. The study group patients were treated with 10 mg of montelukast once in a day for 4 weeks as an add-on drug, whereas the control group received only standard medication of acute bronchial asthma (as per Global Initiative for Asthma guidelines). All the participants were monitored at baseline to every week for a month. RESULTS: All the 100 participants were assessed finally without any dropouts. The baseline characteristics were noted similarly in both groups. The mean age was 35.46 + 13.17 years in the control and 37.86 + 14.43 years in the study group. Majority were males in both the groups. At the end of the 4 weeks of oral montelukast administration, there was improvement in forced expiratory volume in 1 s (FEV1) and peak expiratory flow rate at 2 weeks and 1 month. On many occasions, there was a strong improvement in FEV1 and other clinical parameters after continuous treatment with beta-2 agonists and parenteral corticosteroids for patients with acute asthma. Even though there was no improvement in FEV1/forced vital capacity ratio among both the groups at 2 weeks and 4 weeks, statistically significant improvement was seen between 2 weeks to 1 month on baseline parameters. CONCLUSION: Administration of oral montelukast 10 mg as an add-on drug to standard therapy may help in quick recovery from acute bronchial asthma and relapse.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"19 1","pages":"12 - 16"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80161896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/ijaai.ijaai_48_20
V. Lakshmi, P. Meshram, U. Kumar, Vishwanath Pujari, Pinkutty Sagar
INTRODUCTION: Fractional exhaled nitric oxide (FENO) is a measurement of fractional nitric oxide (NO) concentration in exhaled breath. It is a quantitative, noninvasive, simple, and safe method to measure airway inflammation for the assessment of airways diseases. OBJECTIVE: The study was conducted at the tertiary care hospital to study the FENO levels in newly diagnosed patients of bronchial asthma and chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: A total number of 105 patients were included in the study, diagnosed based on pulmonary function test and symptomatology. FENO levels were measured using Medisoft FENO machine, and the results were analyzed. RESULTS AND CONCLUSIONS: We found that both COPD and bronchial asthma are more prevalent among males. FENO levels were higher in bronchial asthma patients as compared to COPD patients. In bronchial asthma, FENO levels were higher in patients with very severe obstruction, and in COPD, patients with mild obstruction had slightly higher FENO values.
{"title":"The study of fractional exhaled nitric oxide in newly diagnosed cases of bronchial asthma and chronic obstructive pulmonary disease","authors":"V. Lakshmi, P. Meshram, U. Kumar, Vishwanath Pujari, Pinkutty Sagar","doi":"10.4103/ijaai.ijaai_48_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_48_20","url":null,"abstract":"INTRODUCTION: Fractional exhaled nitric oxide (FENO) is a measurement of fractional nitric oxide (NO) concentration in exhaled breath. It is a quantitative, noninvasive, simple, and safe method to measure airway inflammation for the assessment of airways diseases. OBJECTIVE: The study was conducted at the tertiary care hospital to study the FENO levels in newly diagnosed patients of bronchial asthma and chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: A total number of 105 patients were included in the study, diagnosed based on pulmonary function test and symptomatology. FENO levels were measured using Medisoft FENO machine, and the results were analyzed. RESULTS AND CONCLUSIONS: We found that both COPD and bronchial asthma are more prevalent among males. FENO levels were higher in bronchial asthma patients as compared to COPD patients. In bronchial asthma, FENO levels were higher in patients with very severe obstruction, and in COPD, patients with mild obstruction had slightly higher FENO values.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"24 1","pages":"8 - 11"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73844002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.4103/ijaai.ijaai_54_20
Ritika Chhawchharia, Neeraj Gupta, P. Agarwal, A. Sachdev
Milk protein allergy, by non-IgE-mediated immune mechanisms, can present with nonspecific alveolar hemorrhage (Heiner's syndrome). We present the case of a 9-month-old infant with hemoptysis and diffuse pulmonary infiltrates who tested positive for milk, rice, and egg-white allergy on skin prick testing. The child responded to specific dietary elimination with reappearance of symptoms on accidental rice exposure. The present case highlights the need for exploring food allergies, other than milk, as a probable culprit in cases of unexplained hemoptysis.
{"title":"Heiner's syndrome: Exploring beyond milk","authors":"Ritika Chhawchharia, Neeraj Gupta, P. Agarwal, A. Sachdev","doi":"10.4103/ijaai.ijaai_54_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_54_20","url":null,"abstract":"Milk protein allergy, by non-IgE-mediated immune mechanisms, can present with nonspecific alveolar hemorrhage (Heiner's syndrome). We present the case of a 9-month-old infant with hemoptysis and diffuse pulmonary infiltrates who tested positive for milk, rice, and egg-white allergy on skin prick testing. The child responded to specific dietary elimination with reappearance of symptoms on accidental rice exposure. The present case highlights the need for exploring food allergies, other than milk, as a probable culprit in cases of unexplained hemoptysis.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"21 1","pages":"123 - 125"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82060585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.4103/ijaai.ijaai_14_20
M. Kumar, R. Gupta, S. Spalgais, Raj Kumar
BACKGROUND: Skin prick test (SPT) is the “gold standard” in the assessment of sensitivity to inhalant allergens. SPT is performed with antigen extracts from India and evaluated according to the Standard Indian Guidelines. OBJECTIVE: The aim of this study was to determine sensitivity by skin prick test in asthma patients in metropolitical city of Delhi-National Capital Region (NCR). MATERIALS AND METHODS: This is a prospective study of skin prick test with aeroallergens in asthma patients and their combination with clinical diagnosis. Two hundred asthma patients consisting of 81 (40.5%) males and 119 (59.5%) females with a mean age of 30.51 ± 9.85 years aged between 12 and 60 years were selected for study from Viswanathan Chest Hospital, Vallabhbhai Patel Chest Institute, Delhi, between 2017 and 2018. Fifty-eight different common aeroallergen tests were tested through skin prick test (SPT) in patients of bronchial asthma. The sensitivity of all common aeroallergens was analyzed by MS Excel 2010. RESULTS: A significant (2+ and above) skin-positive reaction against aeroallergens was found in 114 (57%) asthma patients. The younger adults aged 21-30 years were the foremost commonly affected group with 84 (43.5%). Among individual allergens, the most common aeroallergens showed a significant positive skin reaction, which were cockroaches 68 (34%) and moth 63 (32.5%), followed by mosquito 61 (30.5%), housefly 55 (27.5%), rice weevil 41 (20.5%), and house dust mite (HDM) 22 (11.0%). CONCLUSION: In the present study, we found that insects (cockroaches, housefly, mosquito, and rice weevil) and HDM are the most common skin sensitive aeroallergens in Delhi-NCR. The sensitization was the most common in the younger age group patients.
{"title":"Sensitivity to common aeroallergens in asthma patients in Delhi-National Capital Region","authors":"M. Kumar, R. Gupta, S. Spalgais, Raj Kumar","doi":"10.4103/ijaai.ijaai_14_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_14_20","url":null,"abstract":"BACKGROUND: Skin prick test (SPT) is the “gold standard” in the assessment of sensitivity to inhalant allergens. SPT is performed with antigen extracts from India and evaluated according to the Standard Indian Guidelines. OBJECTIVE: The aim of this study was to determine sensitivity by skin prick test in asthma patients in metropolitical city of Delhi-National Capital Region (NCR). MATERIALS AND METHODS: This is a prospective study of skin prick test with aeroallergens in asthma patients and their combination with clinical diagnosis. Two hundred asthma patients consisting of 81 (40.5%) males and 119 (59.5%) females with a mean age of 30.51 ± 9.85 years aged between 12 and 60 years were selected for study from Viswanathan Chest Hospital, Vallabhbhai Patel Chest Institute, Delhi, between 2017 and 2018. Fifty-eight different common aeroallergen tests were tested through skin prick test (SPT) in patients of bronchial asthma. The sensitivity of all common aeroallergens was analyzed by MS Excel 2010. RESULTS: A significant (2+ and above) skin-positive reaction against aeroallergens was found in 114 (57%) asthma patients. The younger adults aged 21-30 years were the foremost commonly affected group with 84 (43.5%). Among individual allergens, the most common aeroallergens showed a significant positive skin reaction, which were cockroaches 68 (34%) and moth 63 (32.5%), followed by mosquito 61 (30.5%), housefly 55 (27.5%), rice weevil 41 (20.5%), and house dust mite (HDM) 22 (11.0%). CONCLUSION: In the present study, we found that insects (cockroaches, housefly, mosquito, and rice weevil) and HDM are the most common skin sensitive aeroallergens in Delhi-NCR. The sensitization was the most common in the younger age group patients.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"68 1","pages":"68 - 73"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90685585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.4103/ijaai.ijaai_11_20
Jacqueline Arokiaraj, Alisha Mugunthan, P. Gupta
Interleukins (ILs) were the first expressed by leukocytes that aid in the communication between cells. There have been extensive studies on various types of IL, and it was found that they help in motility, cell growth, and differentiation. They have been grouped into four major groups based upon their structural features. This article explores the characteristics of various IL where studies on each type and its associated autoimmune diseases have been reviewed. This article also highlights on the recent advances and applications in the field.
{"title":"Interleukin types and its application","authors":"Jacqueline Arokiaraj, Alisha Mugunthan, P. Gupta","doi":"10.4103/ijaai.ijaai_11_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_11_20","url":null,"abstract":"Interleukins (ILs) were the first expressed by leukocytes that aid in the communication between cells. There have been extensive studies on various types of IL, and it was found that they help in motility, cell growth, and differentiation. They have been grouped into four major groups based upon their structural features. This article explores the characteristics of various IL where studies on each type and its associated autoimmune diseases have been reviewed. This article also highlights on the recent advances and applications in the field.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"69 1","pages":"57 - 62"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90965069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.4103/ijaai.ijaai_8_20
V. Anand, I. Yadev, S. Bindusha
OBJECTIVE: Studies to find the relation between asthma severity and Vitamin D yielded controversial reports. The objective of the present study is to find the association between severity of asthma and Vitamin D status in children. MATERIALS AND METHODS: This case–control study was conducted in a tertiary teaching hospital. Details were obtained from children with asthma in the age group of 2–12 years who were under follow-up in the respiratory clinic. They were categorized into two groups according to the Global Initiative for Asthma criteria. Those with moderate-to-severe asthma were grouped as cases, and those with mild asthma were grouped as controls. Vitamin D estimation was done, and levels were analyzed with different levels of asthma severity. RESULTS: Among 140 children with childhood asthma studied, 64 (45.7%) had mild asthma and 76 (54.3%) had moderate-to-severe asthma. Vitamin D was insufficient in 55 (72.4%) cases and 30 (46.9%) controls. There was a significant correlation between severity of asthma and Vitamin D levels (P = 0.001) and peripheral eosinophilia (P = 0.02). Logistic regression analysis showed that Vitamin D insufficiency could increase the risk for severe asthma, which remained after adjustment for potential confounders (odds ratio: 2.81 with 95% confidence interval: 1.36–5.82). CONCLUSION: Screening for Vitamin D insufficiency is suggested for children with severe asthma. Vitamin D supplementation could avoid increasing steroid dose/adding new drugs as controllers.
{"title":"Severity of asthma and Vitamin D status in children: A case–control study in a tertiary care center","authors":"V. Anand, I. Yadev, S. Bindusha","doi":"10.4103/ijaai.ijaai_8_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_8_20","url":null,"abstract":"OBJECTIVE: Studies to find the relation between asthma severity and Vitamin D yielded controversial reports. The objective of the present study is to find the association between severity of asthma and Vitamin D status in children. MATERIALS AND METHODS: This case–control study was conducted in a tertiary teaching hospital. Details were obtained from children with asthma in the age group of 2–12 years who were under follow-up in the respiratory clinic. They were categorized into two groups according to the Global Initiative for Asthma criteria. Those with moderate-to-severe asthma were grouped as cases, and those with mild asthma were grouped as controls. Vitamin D estimation was done, and levels were analyzed with different levels of asthma severity. RESULTS: Among 140 children with childhood asthma studied, 64 (45.7%) had mild asthma and 76 (54.3%) had moderate-to-severe asthma. Vitamin D was insufficient in 55 (72.4%) cases and 30 (46.9%) controls. There was a significant correlation between severity of asthma and Vitamin D levels (P = 0.001) and peripheral eosinophilia (P = 0.02). Logistic regression analysis showed that Vitamin D insufficiency could increase the risk for severe asthma, which remained after adjustment for potential confounders (odds ratio: 2.81 with 95% confidence interval: 1.36–5.82). CONCLUSION: Screening for Vitamin D insufficiency is suggested for children with severe asthma. Vitamin D supplementation could avoid increasing steroid dose/adding new drugs as controllers.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"49 1","pages":"103 - 106"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75754502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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