Clinical significance of Alternaria alternata sensitization in patients with allergic rhinitis

PurposeThe aim of the study was to determine the epidemiologic profile of Alternaria alternata (AA)–sensitized patients with allergic rhinitis including coexistence of other atopic diseases, seasonal distribution of AA aeroallergens, age of onset of AA sensitization, and prevalence of sensitization to other allergens.Materials and methodsHistory, clinical examination, and skin prick tests were performed in 623 patients with allergic rhinitis from central Greece. Patients' age, cosensitization, place of living, seasonal distribution, and concomitant symptoms were the variables used to discriminate between AA-sensitized and non–AA–sensitized patients. Significant predictor variables for AA sensitization were determined.ResultsA alternata sensitization was associated with male sex, age younger than 18 years, living in new-built apartments in urban and semiurban areas by the sea, perennial distribution, and nonsmoking. A alternata–sensitized patients were affected more frequently by asthma than non–AA-sensitized patients. No significant differences were found in frequency of bronchitis, cough, conjunctivitis, urticaria, or eczema between patients sensitized or not to AA. Most (66.7%) of AA-sensitized patients were oligosensitized, 18.5% of patients were polysensitized, and 14.8% were monosensitized. Patients' age, cosensitization, place of living, and seasonal distribution were the significant predictor variables discriminating AA-sensitized from non–AA-sensitized patients. These variables correctly classified 79.7% of the patients. A alternata–sensitized patients were more frequently sensitized to grasses, cat epithelia, and flours-rye and less frequently sensitized to artemisia, Dermatophagoides pteronyssinus, D farinae, and chenopodium.ConclusionsPatients meeting the aforementioned epidemiologic criteria should be preferentially offered skin prick tests for AA sensitization.