Rhinitis alone or rhinitis plus asthma: what makes the difference?

This paper examines the clinical expression of asthma in a group of patient s displaying rhinitis according to age, sex, associated symptoms, smoking, familial history of asthma, atopy, type of sensitization to aeroallergens ( pollens and/or indoor allergens), total serum immunoglobulin E (IgE), and b lood eosinophils. A total of 117 adults with rhinitis were analysed on the basis of symptoms. Among them, 51 also displayed asthma, defined as a history of recurrent ep isodes of dyspnoea with a reversible airflow obstruction or a positive meth acholine challenge. The logistic regression analysis carried out in a stepw ise approach, combining several factors, showed that various parameters aff ected the risk of having asthma associated with rhinitis, A further analysi s was made in 74 rhinitis patients comparing 42 subjects without nonallergi c airway hyperresponsiveness (NAAH) to 32 patients with asthma and NAAH, Atopy, high total serum IgE levels, elevated blood eosinophil count and mat ernal asthma were associated with asthma. Furthermore, in atopic patients, pollen sensitization was more closely related to rhinitis alone, whereas se nsitization to indoor allergens was a major determinant for the association of asthma with the symptoms of rhinitis, The same risk factors as those fo und in the clinical part of the study discriminated the patients with rhini tis without NAAH from those with rhinitis, asthma and NAAH. In conclusion, this study gives new insights into the relationships between asthma and rhi nitis.