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Vol. 33. Issue 6.
Pages 272-277 (June 1997)
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Vol. 33. Issue 6.
Pages 272-277 (June 1997)
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Relación entre asma y marcadores de atopia en niños y adultos jóvenes
Association of asthma and markers of atopy in children and young adults
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A. Pereira Vega1, J.A. Maldonado Pérez, R. Ayerbe García, M. Gómez Entrena, J. Grávalos Guzmán
Sección de Neumología. Hospital Juan Ramón Jiménez. Huelva
J.L. Sánchez Ramos*
* Unidad Docente de Medicina Familiar y Comunitaria. Hospital Juan Ramón Jiménez. Huelva
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El objetivo de nuestro trabajo ha sido valorar si la atopia, medida como valor de la IgE total (IgEt) y/o tests cutáneos (TC), se relaciona con el asma bronquial de igual forma en niños y adultos jóvenes. Se han seleccionado aleatoriamente 353 niños de 11-15 años de edad (X¯=12,6) y 208 adultos de 20-44 años ( X¯=32,1), representativos de la ciudad de Huelva. A estos pacientes se les ha realizado: cuestionario sobre síntomas respiratorios (cuestionario del Estudio Europeo de Salud Respiratoria [ECRHS]), prueba de metacolina (MT) medida como PD20 y pruebas de alergia, IgEt y TC. Llamamos asma bronquial a la asociación de haber tenido sibilancias en los últimos 12 meses y MT positiva. El 4,5% de los niños y el 5,3% de los adultos padecían asma bronquial. El valor de IgEt que mejor discriminó entre asmáticos (A) y no asmáticos (NA) fue 145,5 U/ml en niños (sensibilidad [S]: 75% y especificidad [E]: 69,1%) y 96,6 U/ml en adultos (S: 90,9% y E: 73,6%). Para el estudio de las relaciones de la IgEt con el asma bronquial se utilizó su transformación logarítmica (log IgEt). En un análisis simple, la IgEt y los TC se relacionaron con asma bronquial en niños (p=0,002 y p < 0,0001), mientras que en adultos sólo se relacionó con asma bronquial la IgEt (p < 0,001). Mediante regresión logística múltiple, controlando ambos factores simultáneamente, así como el tabaco en los adultos, hemos podido observar que en los niños el asma se asoció con los TC (p=0,023) y no con la IgEt, mientras que en los adultos esta relación se estableció con la IgEt (p=0,0005) y no con los TC. En función de la distinta relación de los marcadores de atopia estudiados (IgEt y TC) con el asma bronquial en niños yadultos jóvenes, nuestros datos sugieren que estos marcadores se manifiestan de diferente forma en las distintas etapas de la vida. Nuestros resultados implican mayor utilidad de los TC en los niños y de la IgE en los adultos.

Palabras clave:
Asma
Atopia
IgE
Tests cutáneos
Niños
Adultos jóvenes

The aim of this study was to assess whether atopy, measured as total IgE level (IgEt) and/or skin test (ST) reactivity is related to bronchial asthma in the same way in children and young adults. Three hundred fifty-three children between 11 and 15 years of age (mean 12.6 years) and 208 adults between 20 and 44 years old (mean 32.1 years) were selected randomly as representative of persons living in the city of Huelva (Spain). All subjects filled out a questionnaire on respiratory symptoms (The European Community Respiratory Health Survey - [ECRHS]) and were given a methacholine challenge test (MT) with results expressed as PD20 as well as IgEt and ST assessments of atopy. We defined bronchial asthma as the association of having experienced wheezing within the last 12 months and having a positive ST. Among children, 4.5% suffered bronchial asthma. Among adults the proportion was 5.3%. The IgEt value that best discriminated between asthmatics and non asthmatics was 145.5 U/ml in children (sensitivity 75% and specificity 69.1%) and 96.6 U/ml in adults (sensitivity 90.9% and specificity 73.6%). A logarithmic transformation (log IgEt) was used to study the relation between bronchial asthma and IgEt. By simple analysis, IgEt and ST were related to bronchial asthma in children (p=0.002 and p < 0.0001, respectively), while only IgEt (p < 0.001) was related in adults. By múltiple regression analysis, controllingfor both factors simultaneously as well as for smoking in adults, we found that ST (p=0.023) but not IgEt was related in children, whereas IgEt (p = 0.0005) but not ST was related in adults. We conclude that the two markers of atopy studied are related to bronchial asthma differently and have different manifestations at different stages of life. ST is more useful in children, whereas IgE determination is of more use in adults.

Key words:
Asthma
Atopy
IgE
Skin tests
Children
Young adults
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Copyright © 1997. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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