A preliminary report on the prevalence and clinical features of allergic rhinitis in ankylosing spondylitis patients

Abstract

Objective: Our aim was to investigate the prevalence and clinical features of allergic rhinitis in patients with ankylosing spondylitis. Methods: This cross-sectional, clinical study was performed on 64 patients (24 females, 40 males) between October 2011 and November 2012. The Score for Allergic Rhinitis (SFAR) questionnaire was carried out to the patients with a recent diagnosis of ankylosing spondylitis. Skin prick test was performed to the cases who responded positively to SFAR. Descriptive parameters, clinical features and skin prick test results were documented. Results: The mean age of the study group was 41.7±11.2. Eight patients (12.5%) were presumably diagnosed for allergic rhinitis according to SFAR questionnaire. Skin prick test yielded positivity for Dermatophagoides farinae and Dermatophagoides pteronyssinus in one of the 8 cases who responded positively for SFAR. The most common symptoms were sneezing (n=15; 23.4%), nasal obstruction (n=12; 18.8%), and nasal itching (n=12; 18.8%). Conclusion: Our results demonstrate that prevalence of allergic rhinitis is lower in ankylosing spondylitis patients. However, clinical and pathophysiological features of allergic rhinitis accompanying autoimmune diseases must be investigated in further trials.

Keywords

• Allergic rhinitis, ankylosing spondylitis, prevalence, symptom, cytokines

Ankilozan spondilit hastalarında alerjik rinit sıklığı ve klinik özelliklerine ilişkin bir ön çalışma

Öz

Amaç: Bu çalışmanın amacı ankilozan spondilit hastalarında alerjik rinit sıklığı ve klinik özelliklerini araştırmaktır. Yöntem: Bu kesitsel, klinik çalışma bir üniversite hastanesinin kulak burun boğaz hastalıkları kliniğinde Ekim 2011 - Kasım 2012 arasında gerçekleştirildi. Toplam 64 ankilozan spondilit hastasına (24 kadın, 40 erkek) "The Score for Allergic Rhinitis" (SFAR) anketi uygulandı. Anket sonucuna göre alerjik rinit olduğu düşünülen olgulara deri testi yapıldı. Tanımlayıcı parametreler, klinik özellikler ve deri testi bulguları analiz edilerek sunuldu. Bulgular: Çalışma grubunda ortalama yaş 41.7±11.2 olarak bulundu. Anket sonucuna göre alerjik riniti olduğu düşünülen 8 hastaya (%12.5) deri testleri yapıldı. Deri testi sonucunda bu olgulardan yalnızca birinde Dermatophagoides farinae ve Dermatophagoides pteronyssinus için pozitiflik saptandı. Ankilozan spondilit hastalarında rinitle ilgili olabilecek klinik bulgulardan hapşırma (n=15; %23.4), burun tıkanıklığı (n=12; 18.8%) ve burun kaşıntısı (n=12; %18.8) gözlendi. Sonuç: Çalışmamızın sonuçlarına göre ankilozan spondilit olgularında alerjik rinit sıklığının daha düşük olduğu gözlenmiştir. Otoimmün hastalıklarda alerjik rinit sıklığı ve klinik bulgularına ilişkin daha ileri çalışmalara gereksinim bulunmaktadır.

Anahtar Kelimeler

• Alerjik rinit, ankilozan spondilit, prevalans, sitokinler

Kaynakça

1. Cingi C, Songu M, Ural A, et al. The Score For Allergic Rhinitis study in Turkey. Am J Rhinol Allergy 2011;25:333–7.
2. Annesi-Maesano I, Didier A, Klossek M, Chanal I, Moreau D, Bousquet J. The score for allergic rhinitis (SFAR): a simple and valid assessment method in population studies. Allergy 2002;57:107–14.
3. Maggi E. The TH1/TH2 paradigm in allergy. Immunotechnology 1998;3:233–44.
4. Ngoc PL, Gold DR, Tzianabos AO, Weiss ST, Celedón JC. Cytokines, allergy, and asthma. Curr Opin Allergy Clin Immunol 2005;5:161–6.
5. Gran JT, Husby G. Clinical, epidemiologic and therapeutic aspects of ankylosing spondylitis. Curr Opin Rheumatol 1998;10:292–8.
6. Smith JA, Märker-Hermann E, Colbert RA. Pathogenesis of anky- losing spondylitis: current concepts. Best Pract Res Clin Rheumatol 2006;20:571–91.
7. Rabin RL, Levinson AI. The nexus between atopic disease and autoimmunity: a review of the epidemiological and mechanistic lit- erature. Clin Exp Immunol 2008;153:19–30.
8. Rudwaleit M, Andermann B, Alten R, et al. Atopic disorders in ankylosing spondylitis and rheumatoid arthritis. Ann Rheum Dis 2002;61:968–74.

9. Abbas AK, Murphy KM, Sher A. Functional diversity of helper T lymphocytes. Nature 1996;383:787–93.
10. Zochling J, Bohl-Bühler MH, Baraliakos X, Feldtkeller E, Braun J. The high prevalence of infections and allergic symptoms in patients with ankylosing spondylitis is associated with clinical symptoms. Clin Rheumatol 2006;25:648–8. Erratum in: Clin Rheumatol 2006;25:659.
11. Bergamaschi R, Villani S, Crabbio M, et al. Inverse relationship between multiple sclerosis and allergic respiratory diseases. Neurol Sci 2009;30:115–8.
12. Ostensen M. The effect of pregnancy on ankylosing spondylitis,psoriatic arthritis, and juvenile rheumatoid arthritis. Am J Reprod Immunol 1992;28:235–7.
13. Heinzerling L, Mari A, Bergmann KC, et al. The skin prick test - European standards. Clin Transl Allergy 2013;3:3.
14. Scadding GK. Non-allergic rhinitis: diagnosis and management. Curr Opin Allergy Clin Immun 2001;1:15–20.
15. Bachert C. Persistent rhinitis -allergic or nonallergic? Allergy 2004;59 Suppl 76:11–5.
16. Pagnoux C, Wolter NE. Vasculitis of the upper airways. Swiss Med Wkly 2012;142:w13541.