Author/Authors :
Agache, Ioana Transylvania University - Faculty of Medicine - Department of Allergy and Clinical Immunology, Romania , Duca, Liliana Transylvania University - Faculty of Medicine - Department of Allergy and Clinical Immunology, Romania , Anghel, Mariana Brasov County Hospital - Immunology Laboratory, Romania , Pamfil, Gheorghe Transylvania University - Faculty of Medicine - Department of Biostatistics, Romania
Abstract :
Several studies reported the appearance of asthma and autoimmune conditions in the
same patient, but the clinical significance of this association was not yet assessed.
One hundred asthmatic patients were observed for one year evolution with death, severe
exacerbations, intake of > 1000 micrograms of beclometasone or equivalent (high ICS) and
FEV1 decline >100 ml, in relation with ANA (ELISA), sputum and blood eosinophilia
(EO), NSAID intolerance, BMI >25, chronic rhinosinusitis, smoking status and FEV1
<30% predicted (low FEV1).
After 1 year of observation, there were 5 deaths, 28 severe asthma exacerbations requiring
hospitalisations, 24 cases requiring high inhaled corticosteroid intake, and 19 patients with
fast FEV1 decline (>100 ml/year). Multiple regression analysis pointed out several different
independent risk factors for severe asthma evolution: for death presence of ANA (P=0.037),
NSAID intolerance (P<0.001) and low FEV1 (P=0.021); for evolution with severe exacerbations
ANA (p=0.011), sputum EO (P<0.001), smoking (P=0.044) and NSAID intolerance
(P=0.022); for high ICS intake ANA (P=0.036), sputum EO (P=0.026) and low FEV1
(P=0.006); for FEV1 decline >100 ml ANA (P=0.006), sputum EO (P=0.037), BMI>25
(P=0.046) and NSAID intolerance (P=0.017)
The presence of ANA is an independent risk factor in asthma for evolution with death,
severe exacerbations, high inhaled corticosteroid intake and FEV1 decline >100 ml.
Keywords :
Antinuclear antibodies , Asthma phenotype , Risk factors , Severe asthma
