Evaluation of Asthma, Allergic Rhinitis, Eczema and Sensitization among the Grade-7 Students of Iqaluit

Abstract

; Klinikum rechts der Isar. RATIONALE: Hereditary angioedema is a disease which leads to recurrent swelling of the skin and mucous membranes including the upper airway tract. Clinicians are occasionally confronted with patients who have recurrent attacks despite treatment with C1-Inhibtor concentration or B2-Receptor Inhibitor. The goal of this study is to investigate repeat attacks which re-occur within a week (''cluster-attacks'') after treatment, to determine why they occur and with what factors they may be associated with, and hereby prevent their occurrence. METHODS: We conducted a multi-center mixed retrospective/prospective study data acquisition of all documented attacks from our HAE patient collective (n5156) from 2015 to 2018. RESULTS: 85% of our patients agreed to participate in the study. 10% (n515) had cluster-attacks, with a total of 126 cluster-attacks. 66% of all cluster-attacks were caused by exogenous stimuli (36% due to psychological stress, 27% due to physical stimuli, and 4% due to menstruation, 1% due to infections). The rate of cluster attacks was lower for patients receiving prophylactic therapy than for patients receiving on-demand therapy (7 versus 14%). A significantly lower ''time to repeat attack'' could be found for patients who received an on-demand therapy, as compared to those with a prophylactic therapy. Redosing rates, when stratified according to pharmaceutical product, showed prophylactically treated patients not redosing, whereas on-demand patients redosed a total of 14 times, 7 times using C1-inhibitor substrate and 7 times using B2-receptor inhibitor. CONCLUSIONS: Cluster-attacks are most commonly due to psychsomaticstress andphysical stimuli.In patients who are prone to cluster-attacks a prophylaxis should be considered.