2011 AAAAI Annual Meeting

SAN FRANCISCO – Increase in sputum hyaluronan may serve as a noninvasive biomarker of airway remodeling in patients with severe asthma, results from a small novel study demonstrated.

While previous studies have shown that hyaluronan and versican are increased in the extracellular matrix of patients with obstructive lung disease, researchers led by Dr. Andrew G. Ayars, a fellow in allergy and immunology at the University of Washington, Seattle, set out to evaluate levels of hyaluronan and versican in sputum supernatants of 17 prednisone-dependent asthmatics who were randomized to either an anti-interleukin-5 antibody (mepolizumab) or placebo for 16 weeks.

In their abstract, which was unveiled during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology, the researchers stated that hyaluronan is a glycosaminoglycan, which "acts as a vital structural component in connective tissues and is important in cell migration, immune cell adhesion, activation, and intracellular signaling." They described versican as "a large extracellular matrix proteoglycan that is present in a variety of human tissues," noting that it binds to hyaluronan.

Seven patients were treated with mepolizumab (at a dose of 750 mg) and 10 were treated with placebo administered intravenously over a 30-minute period at weeks 2, 6, 10, 14, and 18. Patients underwent a predefined prednisone tapering schedule if they remained exacerbation free at follow-up visits. The researchers performed spirometry and used enzyme-linked immunosorbent assay (ELISA) to measure levels of sputum hyaluronan and versican before and after treatment.

Study participants had a mean age of 56 years in the mepolizumab group and 58 years in the placebo group, and men made up 44% of the mepolizumab group and 73% of the placebo group.

Dr. Ayars and his associates observed a significant increase in sputum hyaluronan in the placebo group following prednisone taper (P = .003). They also observed a significantly lower level of sputum hyaluronan after treatment with mepolizumab vs. treatment with placebo (P = .01).

A numerical, nonsignificant increase in sputum versican was seen in the placebo group, while a numerical, nonsignificant decrease was seen in the mepolizumab group.

Dr. Ayars acknowledged that the findings are preliminary, and said that a current study is underway to test the association in patients with mild asthma treated with 2-4 weeks of inhaled corticosteroids.

Dr. Ayars said that he had no relevant financial conflicts to disclose.

SAN FRANCISCO – Increase in sputum hyaluronan may serve as a noninvasive biomarker of airway remodeling in patients with severe asthma, results from a small novel study demonstrated.

While previous studies have shown that hyaluronan and versican are increased in the extracellular matrix of patients with obstructive lung disease, researchers led by Dr. Andrew G. Ayars, a fellow in allergy and immunology at the University of Washington, Seattle, set out to evaluate levels of hyaluronan and versican in sputum supernatants of 17 prednisone-dependent asthmatics who were randomized to either an anti-interleukin-5 antibody (mepolizumab) or placebo for 16 weeks.

In their abstract, which was unveiled during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology, the researchers stated that hyaluronan is a glycosaminoglycan, which "acts as a vital structural component in connective tissues and is important in cell migration, immune cell adhesion, activation, and intracellular signaling." They described versican as "a large extracellular matrix proteoglycan that is present in a variety of human tissues," noting that it binds to hyaluronan.

Seven patients were treated with mepolizumab (at a dose of 750 mg) and 10 were treated with placebo administered intravenously over a 30-minute period at weeks 2, 6, 10, 14, and 18. Patients underwent a predefined prednisone tapering schedule if they remained exacerbation free at follow-up visits. The researchers performed spirometry and used enzyme-linked immunosorbent assay (ELISA) to measure levels of sputum hyaluronan and versican before and after treatment.

Study participants had a mean age of 56 years in the mepolizumab group and 58 years in the placebo group, and men made up 44% of the mepolizumab group and 73% of the placebo group.

Dr. Ayars and his associates observed a significant increase in sputum hyaluronan in the placebo group following prednisone taper (P = .003). They also observed a significantly lower level of sputum hyaluronan after treatment with mepolizumab vs. treatment with placebo (P = .01).

A numerical, nonsignificant increase in sputum versican was seen in the placebo group, while a numerical, nonsignificant decrease was seen in the mepolizumab group.

Dr. Ayars acknowledged that the findings are preliminary, and said that a current study is underway to test the association in patients with mild asthma treated with 2-4 weeks of inhaled corticosteroids.

Dr. Ayars said that he had no relevant financial conflicts to disclose.

SAN FRANCISCO – Increase in sputum hyaluronan may serve as a noninvasive biomarker of airway remodeling in patients with severe asthma, results from a small novel study demonstrated.

While previous studies have shown that hyaluronan and versican are increased in the extracellular matrix of patients with obstructive lung disease, researchers led by Dr. Andrew G. Ayars, a fellow in allergy and immunology at the University of Washington, Seattle, set out to evaluate levels of hyaluronan and versican in sputum supernatants of 17 prednisone-dependent asthmatics who were randomized to either an anti-interleukin-5 antibody (mepolizumab) or placebo for 16 weeks.

In their abstract, which was unveiled during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology, the researchers stated that hyaluronan is a glycosaminoglycan, which "acts as a vital structural component in connective tissues and is important in cell migration, immune cell adhesion, activation, and intracellular signaling." They described versican as "a large extracellular matrix proteoglycan that is present in a variety of human tissues," noting that it binds to hyaluronan.

Seven patients were treated with mepolizumab (at a dose of 750 mg) and 10 were treated with placebo administered intravenously over a 30-minute period at weeks 2, 6, 10, 14, and 18. Patients underwent a predefined prednisone tapering schedule if they remained exacerbation free at follow-up visits. The researchers performed spirometry and used enzyme-linked immunosorbent assay (ELISA) to measure levels of sputum hyaluronan and versican before and after treatment.

Study participants had a mean age of 56 years in the mepolizumab group and 58 years in the placebo group, and men made up 44% of the mepolizumab group and 73% of the placebo group.

Dr. Ayars and his associates observed a significant increase in sputum hyaluronan in the placebo group following prednisone taper (P = .003). They also observed a significantly lower level of sputum hyaluronan after treatment with mepolizumab vs. treatment with placebo (P = .01).

A numerical, nonsignificant increase in sputum versican was seen in the placebo group, while a numerical, nonsignificant decrease was seen in the mepolizumab group.

Dr. Ayars acknowledged that the findings are preliminary, and said that a current study is underway to test the association in patients with mild asthma treated with 2-4 weeks of inhaled corticosteroids.

Dr. Ayars said that he had no relevant financial conflicts to disclose.

SAN FRANCISCO – The best way to prepare for optimal delivery of care to anaphylaxis patients is to make sure you have the proper equipment on hand.

Suggested universal equipment includes a stethoscope and sphygmomanometer, epinephrine, oxygen, IV fluid, tourniquets, syringes, hypodermic needles, and large-bore needles, according to a 2010 practice parameter update developed by the American Academy of Allergy, Asthma, and Immunology; the American College of Allergy, Asthma, and Immunology; and the Joint Council of Allergy, Asthma, and Immunology.

"These should be available in all medical facilities and ready to use at the drop of a hat," Dr. Phillip Lieberman, a chief editor of the practice parameter, said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Depending on the availability of emergency support services, the parameter advises having on hand a one-way valve face mask, oxygen inlet port, diphenhydramine, corticosteroids for IV use, vasopressors, and atropine (J. Allergy Clin. Immunol. 2010;126:477-80). In addition, some clinicians may strongly consider having glucagon available, as well as a defibrillator and oral airway devices.

Prompt recognition of anaphylaxis signs and symptoms is crucial, said Dr. Lieberman of the departments of medicine and pediatrics at the University of Tennessee, Memphis.

"If there is any doubt, it is generally better to administer epinephrine, because a sin of omission in this case exceeds a sin of commission," he said. "The drug in general is safe to use and it very rarely causes any significant side effects."

The parameter also noted that "the more rapid the treatment, the better the outcome. Therefore, personnel in a medical office dealing directly with the patient’s medical care should be familiar with the manifestations of anaphylaxis and be able to recognize an event quickly."

Dr. Lieberman said this means that "you need to charge your medical personnel with the task of being able to recognize symptoms that are early suggestions of an anaphylactic event."

The parameter lists epinephrine and oxygen as the most important therapeutic agents to administer in anaphylaxis. It calls epinephrine "the drug of choice, and the appropriate dose should be administered promptly at the onset of apparent anaphylaxis. In general, treatment in order of importance is: epinephrine, patient position, oxygen, intravenous fluids, nebulized therapy, vasopressors, antihistamines, corticosteroids, and other agents."

Dr. Lieberman disclosed that he is a consultant or paid speaker for Dey, Sanofi-Aventis, Genentech, Ista, Merck-Schering, Teva, Novartis, Meda, and Alcon.

SAN FRANCISCO – The best way to prepare for optimal delivery of care to anaphylaxis patients is to make sure you have the proper equipment on hand.

Suggested universal equipment includes a stethoscope and sphygmomanometer, epinephrine, oxygen, IV fluid, tourniquets, syringes, hypodermic needles, and large-bore needles, according to a 2010 practice parameter update developed by the American Academy of Allergy, Asthma, and Immunology; the American College of Allergy, Asthma, and Immunology; and the Joint Council of Allergy, Asthma, and Immunology.

"These should be available in all medical facilities and ready to use at the drop of a hat," Dr. Phillip Lieberman, a chief editor of the practice parameter, said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Depending on the availability of emergency support services, the parameter advises having on hand a one-way valve face mask, oxygen inlet port, diphenhydramine, corticosteroids for IV use, vasopressors, and atropine (J. Allergy Clin. Immunol. 2010;126:477-80). In addition, some clinicians may strongly consider having glucagon available, as well as a defibrillator and oral airway devices.

Prompt recognition of anaphylaxis signs and symptoms is crucial, said Dr. Lieberman of the departments of medicine and pediatrics at the University of Tennessee, Memphis.

"If there is any doubt, it is generally better to administer epinephrine, because a sin of omission in this case exceeds a sin of commission," he said. "The drug in general is safe to use and it very rarely causes any significant side effects."

The parameter also noted that "the more rapid the treatment, the better the outcome. Therefore, personnel in a medical office dealing directly with the patient’s medical care should be familiar with the manifestations of anaphylaxis and be able to recognize an event quickly."

Dr. Lieberman said this means that "you need to charge your medical personnel with the task of being able to recognize symptoms that are early suggestions of an anaphylactic event."

The parameter lists epinephrine and oxygen as the most important therapeutic agents to administer in anaphylaxis. It calls epinephrine "the drug of choice, and the appropriate dose should be administered promptly at the onset of apparent anaphylaxis. In general, treatment in order of importance is: epinephrine, patient position, oxygen, intravenous fluids, nebulized therapy, vasopressors, antihistamines, corticosteroids, and other agents."

Dr. Lieberman disclosed that he is a consultant or paid speaker for Dey, Sanofi-Aventis, Genentech, Ista, Merck-Schering, Teva, Novartis, Meda, and Alcon.

SAN FRANCISCO – The best way to prepare for optimal delivery of care to anaphylaxis patients is to make sure you have the proper equipment on hand.

Suggested universal equipment includes a stethoscope and sphygmomanometer, epinephrine, oxygen, IV fluid, tourniquets, syringes, hypodermic needles, and large-bore needles, according to a 2010 practice parameter update developed by the American Academy of Allergy, Asthma, and Immunology; the American College of Allergy, Asthma, and Immunology; and the Joint Council of Allergy, Asthma, and Immunology.

"These should be available in all medical facilities and ready to use at the drop of a hat," Dr. Phillip Lieberman, a chief editor of the practice parameter, said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Depending on the availability of emergency support services, the parameter advises having on hand a one-way valve face mask, oxygen inlet port, diphenhydramine, corticosteroids for IV use, vasopressors, and atropine (J. Allergy Clin. Immunol. 2010;126:477-80). In addition, some clinicians may strongly consider having glucagon available, as well as a defibrillator and oral airway devices.

Prompt recognition of anaphylaxis signs and symptoms is crucial, said Dr. Lieberman of the departments of medicine and pediatrics at the University of Tennessee, Memphis.

"If there is any doubt, it is generally better to administer epinephrine, because a sin of omission in this case exceeds a sin of commission," he said. "The drug in general is safe to use and it very rarely causes any significant side effects."

The parameter also noted that "the more rapid the treatment, the better the outcome. Therefore, personnel in a medical office dealing directly with the patient’s medical care should be familiar with the manifestations of anaphylaxis and be able to recognize an event quickly."

Dr. Lieberman said this means that "you need to charge your medical personnel with the task of being able to recognize symptoms that are early suggestions of an anaphylactic event."

The parameter lists epinephrine and oxygen as the most important therapeutic agents to administer in anaphylaxis. It calls epinephrine "the drug of choice, and the appropriate dose should be administered promptly at the onset of apparent anaphylaxis. In general, treatment in order of importance is: epinephrine, patient position, oxygen, intravenous fluids, nebulized therapy, vasopressors, antihistamines, corticosteroids, and other agents."

Dr. Lieberman disclosed that he is a consultant or paid speaker for Dey, Sanofi-Aventis, Genentech, Ista, Merck-Schering, Teva, Novartis, Meda, and Alcon.

SAN FRANCISCO – The best way to prepare for optimal delivery of care to anaphylaxis patients is to make sure you have the proper equipment on hand.

Suggested universal equipment includes a stethoscope and sphygmomanometer, epinephrine, oxygen, IV fluid, tourniquets, syringes, hypodermic needles, and large-bore needles, according to a 2010 practice parameter update developed by the American Academy of Allergy, Asthma, and Immunology; the American College of Allergy, Asthma, and Immunology; and the Joint Council of Allergy, Asthma, and Immunology.

"These should be available in all medical facilities and ready to use at the drop of a hat," Dr. Phillip Lieberman, a chief editor of the practice parameter, said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Depending on the availability of emergency support services, the parameter advises having on hand a one-way valve face mask, oxygen inlet port, diphenhydramine, corticosteroids for IV use, vasopressors, and atropine (J. Allergy Clin. Immunol. 2010;126:477-80). In addition, some clinicians may strongly consider having glucagon available, as well as a defibrillator and oral airway devices.

Prompt recognition of anaphylaxis signs and symptoms is crucial, said Dr. Lieberman of the departments of medicine and pediatrics at the University of Tennessee, Memphis.

"If there is any doubt, it is generally better to administer epinephrine, because a sin of omission in this case exceeds a sin of commission," he said. "The drug in general is safe to use and it very rarely causes any significant side effects."

The parameter also noted that "the more rapid the treatment, the better the outcome. Therefore, personnel in a medical office dealing directly with the patient’s medical care should be familiar with the manifestations of anaphylaxis and be able to recognize an event quickly."

Dr. Lieberman said this means that "you need to charge your medical personnel with the task of being able to recognize symptoms that are early suggestions of an anaphylactic event."

The parameter lists epinephrine and oxygen as the most important therapeutic agents to administer in anaphylaxis. It calls epinephrine "the drug of choice, and the appropriate dose should be administered promptly at the onset of apparent anaphylaxis. In general, treatment in order of importance is: epinephrine, patient position, oxygen, intravenous fluids, nebulized therapy, vasopressors, antihistamines, corticosteroids, and other agents."

Dr. Lieberman disclosed that he is a consultant or paid speaker for Dey, Sanofi-Aventis, Genentech, Ista, Merck-Schering, Teva, Novartis, Meda, and Alcon.

SAN FRANCISCO – The best way to prepare for optimal delivery of care to anaphylaxis patients is to make sure you have the proper equipment on hand.

Suggested universal equipment includes a stethoscope and sphygmomanometer, epinephrine, oxygen, IV fluid, tourniquets, syringes, hypodermic needles, and large-bore needles, according to a 2010 practice parameter update developed by the American Academy of Allergy, Asthma, and Immunology; the American College of Allergy, Asthma, and Immunology; and the Joint Council of Allergy, Asthma, and Immunology.

"These should be available in all medical facilities and ready to use at the drop of a hat," Dr. Phillip Lieberman, a chief editor of the practice parameter, said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Depending on the availability of emergency support services, the parameter advises having on hand a one-way valve face mask, oxygen inlet port, diphenhydramine, corticosteroids for IV use, vasopressors, and atropine (J. Allergy Clin. Immunol. 2010;126:477-80). In addition, some clinicians may strongly consider having glucagon available, as well as a defibrillator and oral airway devices.

Prompt recognition of anaphylaxis signs and symptoms is crucial, said Dr. Lieberman of the departments of medicine and pediatrics at the University of Tennessee, Memphis.

"If there is any doubt, it is generally better to administer epinephrine, because a sin of omission in this case exceeds a sin of commission," he said. "The drug in general is safe to use and it very rarely causes any significant side effects."

The parameter also noted that "the more rapid the treatment, the better the outcome. Therefore, personnel in a medical office dealing directly with the patient’s medical care should be familiar with the manifestations of anaphylaxis and be able to recognize an event quickly."

Dr. Lieberman said this means that "you need to charge your medical personnel with the task of being able to recognize symptoms that are early suggestions of an anaphylactic event."

The parameter lists epinephrine and oxygen as the most important therapeutic agents to administer in anaphylaxis. It calls epinephrine "the drug of choice, and the appropriate dose should be administered promptly at the onset of apparent anaphylaxis. In general, treatment in order of importance is: epinephrine, patient position, oxygen, intravenous fluids, nebulized therapy, vasopressors, antihistamines, corticosteroids, and other agents."

Dr. Lieberman disclosed that he is a consultant or paid speaker for Dey, Sanofi-Aventis, Genentech, Ista, Merck-Schering, Teva, Novartis, Meda, and Alcon.

SAN FRANCISCO – The best way to prepare for optimal delivery of care to anaphylaxis patients is to make sure you have the proper equipment on hand.

Suggested universal equipment includes a stethoscope and sphygmomanometer, epinephrine, oxygen, IV fluid, tourniquets, syringes, hypodermic needles, and large-bore needles, according to a 2010 practice parameter update developed by the American Academy of Allergy, Asthma, and Immunology; the American College of Allergy, Asthma, and Immunology; and the Joint Council of Allergy, Asthma, and Immunology.

"These should be available in all medical facilities and ready to use at the drop of a hat," Dr. Phillip Lieberman, a chief editor of the practice parameter, said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Depending on the availability of emergency support services, the parameter advises having on hand a one-way valve face mask, oxygen inlet port, diphenhydramine, corticosteroids for IV use, vasopressors, and atropine (J. Allergy Clin. Immunol. 2010;126:477-80). In addition, some clinicians may strongly consider having glucagon available, as well as a defibrillator and oral airway devices.

Prompt recognition of anaphylaxis signs and symptoms is crucial, said Dr. Lieberman of the departments of medicine and pediatrics at the University of Tennessee, Memphis.

"If there is any doubt, it is generally better to administer epinephrine, because a sin of omission in this case exceeds a sin of commission," he said. "The drug in general is safe to use and it very rarely causes any significant side effects."

The parameter also noted that "the more rapid the treatment, the better the outcome. Therefore, personnel in a medical office dealing directly with the patient’s medical care should be familiar with the manifestations of anaphylaxis and be able to recognize an event quickly."

Dr. Lieberman said this means that "you need to charge your medical personnel with the task of being able to recognize symptoms that are early suggestions of an anaphylactic event."

The parameter lists epinephrine and oxygen as the most important therapeutic agents to administer in anaphylaxis. It calls epinephrine "the drug of choice, and the appropriate dose should be administered promptly at the onset of apparent anaphylaxis. In general, treatment in order of importance is: epinephrine, patient position, oxygen, intravenous fluids, nebulized therapy, vasopressors, antihistamines, corticosteroids, and other agents."

Dr. Lieberman disclosed that he is a consultant or paid speaker for Dey, Sanofi-Aventis, Genentech, Ista, Merck-Schering, Teva, Novartis, Meda, and Alcon.

SAN FRANCISCO – Parents of urban children with asthma tend to overestimate their child’s asthma control, but the factors predicting this association remain unclear, a study has shown.

"There’s a disconnect," lead investigator Joy N. Saams, R.N., said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "We tried to look for what made overestimating parents different from other parents. We had a hard time setting them apart."

In an effort to determine if parents’ perception of their child’s asthma was consistent with their child’s asthma control, Ms. Saams and her associates evaluated data from a 1-year observational study of 150 children aged 5-17 years with persistent asthma who lived in Baltimore. All children underwent spirometry. Days of symptoms and rescue medication use as well as parent/guardian perception of the child’s asthma were determined by questionnaire, said Ms. Saams of the division of pediatric allergy and immunology at Johns Hopkins University, Baltimore.

She and her associates defined misperception of asthma control as parent report of well-controlled asthma when the child’s asthma met National Asthma Education and Prevention Program criteria for disease that is not well controlled or is poorly controlled. They administered a questionnaire to determine family income, education level of the parents, and risk of depression, which was defined as scoring higher than 8 on the 10-item Center for Epidemiologic Studies Depression Scale.

The mean age of the children was 12 years, 57% were male, 91% were African American, and 53% were from households with an income of less than $25,000 per year. Nearly half of the children (43%) had asthma that was not well controlled, 32% had asthma that was poorly controlled, and 25% had asthma that was well controlled. Boys were significantly more likely than girls to have uncontrolled asthma (81% vs. 67%), Ms. Saams reported.

Parents of children with well-controlled asthma were significantly more likely to believe that their child’s asthma was well controlled, compared with parents of children with uncontrolled asthma (90% vs. 67%). "The good news may be that 90% of parents correctly identified well-controlled asthma, but 67% did not recognize uncontrolled asthma," Ms. Saams commented. "The story isn’t about who got it right, but who got it wrong."

When only reported symptoms and use of short-acting beta-agonists determined control, 62% of parents still believed that their child’s asthma was well controlled when it was not.

Although there were no statistically significant predictors of parent overestimation of asthma control, parents with less education and those with older children were more likely to overestimate their child’s asthma control, compared with parents who had higher levels of education and younger children.

There was no significant association between overestimating asthma control and increasing use of health services, but a larger percentage of children whose parents overestimated disease control had acute health care visits (56% vs. 45% among parents who did not overestimate asthma control).

The researchers concluded that parents of urban children with persistent asthma may benefit from explicit education regarding assessment of asthma control. "When you’re working with a parent and imparting education regarding asthma, pay attention to their background," Ms. Saams advised. "Are you reaching them at their level of understanding? Help them realize not only when their child’s having symptoms, but [also] that when they do have symptoms, that indicates a problem."

The study was funded by grants from the National Institute of Environmental Health Sciences and the National Institute of Allergy and Infectious Diseases.

Ms. Saams said that she had no relevant financial disclosures.

SAN FRANCISCO – Parents of urban children with asthma tend to overestimate their child’s asthma control, but the factors predicting this association remain unclear, a study has shown.

"There’s a disconnect," lead investigator Joy N. Saams, R.N., said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "We tried to look for what made overestimating parents different from other parents. We had a hard time setting them apart."

In an effort to determine if parents’ perception of their child’s asthma was consistent with their child’s asthma control, Ms. Saams and her associates evaluated data from a 1-year observational study of 150 children aged 5-17 years with persistent asthma who lived in Baltimore. All children underwent spirometry. Days of symptoms and rescue medication use as well as parent/guardian perception of the child’s asthma were determined by questionnaire, said Ms. Saams of the division of pediatric allergy and immunology at Johns Hopkins University, Baltimore.

She and her associates defined misperception of asthma control as parent report of well-controlled asthma when the child’s asthma met National Asthma Education and Prevention Program criteria for disease that is not well controlled or is poorly controlled. They administered a questionnaire to determine family income, education level of the parents, and risk of depression, which was defined as scoring higher than 8 on the 10-item Center for Epidemiologic Studies Depression Scale.

The mean age of the children was 12 years, 57% were male, 91% were African American, and 53% were from households with an income of less than $25,000 per year. Nearly half of the children (43%) had asthma that was not well controlled, 32% had asthma that was poorly controlled, and 25% had asthma that was well controlled. Boys were significantly more likely than girls to have uncontrolled asthma (81% vs. 67%), Ms. Saams reported.

Parents of children with well-controlled asthma were significantly more likely to believe that their child’s asthma was well controlled, compared with parents of children with uncontrolled asthma (90% vs. 67%). "The good news may be that 90% of parents correctly identified well-controlled asthma, but 67% did not recognize uncontrolled asthma," Ms. Saams commented. "The story isn’t about who got it right, but who got it wrong."

When only reported symptoms and use of short-acting beta-agonists determined control, 62% of parents still believed that their child’s asthma was well controlled when it was not.

Although there were no statistically significant predictors of parent overestimation of asthma control, parents with less education and those with older children were more likely to overestimate their child’s asthma control, compared with parents who had higher levels of education and younger children.

There was no significant association between overestimating asthma control and increasing use of health services, but a larger percentage of children whose parents overestimated disease control had acute health care visits (56% vs. 45% among parents who did not overestimate asthma control).

The researchers concluded that parents of urban children with persistent asthma may benefit from explicit education regarding assessment of asthma control. "When you’re working with a parent and imparting education regarding asthma, pay attention to their background," Ms. Saams advised. "Are you reaching them at their level of understanding? Help them realize not only when their child’s having symptoms, but [also] that when they do have symptoms, that indicates a problem."

The study was funded by grants from the National Institute of Environmental Health Sciences and the National Institute of Allergy and Infectious Diseases.

Ms. Saams said that she had no relevant financial disclosures.

SAN FRANCISCO – Parents of urban children with asthma tend to overestimate their child’s asthma control, but the factors predicting this association remain unclear, a study has shown.

"There’s a disconnect," lead investigator Joy N. Saams, R.N., said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "We tried to look for what made overestimating parents different from other parents. We had a hard time setting them apart."

In an effort to determine if parents’ perception of their child’s asthma was consistent with their child’s asthma control, Ms. Saams and her associates evaluated data from a 1-year observational study of 150 children aged 5-17 years with persistent asthma who lived in Baltimore. All children underwent spirometry. Days of symptoms and rescue medication use as well as parent/guardian perception of the child’s asthma were determined by questionnaire, said Ms. Saams of the division of pediatric allergy and immunology at Johns Hopkins University, Baltimore.

She and her associates defined misperception of asthma control as parent report of well-controlled asthma when the child’s asthma met National Asthma Education and Prevention Program criteria for disease that is not well controlled or is poorly controlled. They administered a questionnaire to determine family income, education level of the parents, and risk of depression, which was defined as scoring higher than 8 on the 10-item Center for Epidemiologic Studies Depression Scale.

The mean age of the children was 12 years, 57% were male, 91% were African American, and 53% were from households with an income of less than $25,000 per year. Nearly half of the children (43%) had asthma that was not well controlled, 32% had asthma that was poorly controlled, and 25% had asthma that was well controlled. Boys were significantly more likely than girls to have uncontrolled asthma (81% vs. 67%), Ms. Saams reported.

Parents of children with well-controlled asthma were significantly more likely to believe that their child’s asthma was well controlled, compared with parents of children with uncontrolled asthma (90% vs. 67%). "The good news may be that 90% of parents correctly identified well-controlled asthma, but 67% did not recognize uncontrolled asthma," Ms. Saams commented. "The story isn’t about who got it right, but who got it wrong."

When only reported symptoms and use of short-acting beta-agonists determined control, 62% of parents still believed that their child’s asthma was well controlled when it was not.

Although there were no statistically significant predictors of parent overestimation of asthma control, parents with less education and those with older children were more likely to overestimate their child’s asthma control, compared with parents who had higher levels of education and younger children.

There was no significant association between overestimating asthma control and increasing use of health services, but a larger percentage of children whose parents overestimated disease control had acute health care visits (56% vs. 45% among parents who did not overestimate asthma control).

The researchers concluded that parents of urban children with persistent asthma may benefit from explicit education regarding assessment of asthma control. "When you’re working with a parent and imparting education regarding asthma, pay attention to their background," Ms. Saams advised. "Are you reaching them at their level of understanding? Help them realize not only when their child’s having symptoms, but [also] that when they do have symptoms, that indicates a problem."

The study was funded by grants from the National Institute of Environmental Health Sciences and the National Institute of Allergy and Infectious Diseases.

Ms. Saams said that she had no relevant financial disclosures.

SAN FRANCISCO – Parents of urban children with asthma tend to overestimate their child’s asthma control, but the factors predicting this association remain unclear, a study has shown.

"There’s a disconnect," lead investigator Joy N. Saams, R.N., said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "We tried to look for what made overestimating parents different from other parents. We had a hard time setting them apart."

In an effort to determine if parents’ perception of their child’s asthma was consistent with their child’s asthma control, Ms. Saams and her associates evaluated data from a 1-year observational study of 150 children aged 5-17 years with persistent asthma who lived in Baltimore. All children underwent spirometry. Days of symptoms and rescue medication use as well as parent/guardian perception of the child’s asthma were determined by questionnaire, said Ms. Saams of the division of pediatric allergy and immunology at Johns Hopkins University, Baltimore.

She and her associates defined misperception of asthma control as parent report of well-controlled asthma when the child’s asthma met National Asthma Education and Prevention Program criteria for disease that is not well controlled or is poorly controlled. They administered a questionnaire to determine family income, education level of the parents, and risk of depression, which was defined as scoring higher than 8 on the 10-item Center for Epidemiologic Studies Depression Scale.

The mean age of the children was 12 years, 57% were male, 91% were African American, and 53% were from households with an income of less than $25,000 per year. Nearly half of the children (43%) had asthma that was not well controlled, 32% had asthma that was poorly controlled, and 25% had asthma that was well controlled. Boys were significantly more likely than girls to have uncontrolled asthma (81% vs. 67%), Ms. Saams reported.

Parents of children with well-controlled asthma were significantly more likely to believe that their child’s asthma was well controlled, compared with parents of children with uncontrolled asthma (90% vs. 67%). "The good news may be that 90% of parents correctly identified well-controlled asthma, but 67% did not recognize uncontrolled asthma," Ms. Saams commented. "The story isn’t about who got it right, but who got it wrong."

When only reported symptoms and use of short-acting beta-agonists determined control, 62% of parents still believed that their child’s asthma was well controlled when it was not.

Although there were no statistically significant predictors of parent overestimation of asthma control, parents with less education and those with older children were more likely to overestimate their child’s asthma control, compared with parents who had higher levels of education and younger children.

There was no significant association between overestimating asthma control and increasing use of health services, but a larger percentage of children whose parents overestimated disease control had acute health care visits (56% vs. 45% among parents who did not overestimate asthma control).

The researchers concluded that parents of urban children with persistent asthma may benefit from explicit education regarding assessment of asthma control. "When you’re working with a parent and imparting education regarding asthma, pay attention to their background," Ms. Saams advised. "Are you reaching them at their level of understanding? Help them realize not only when their child’s having symptoms, but [also] that when they do have symptoms, that indicates a problem."

The study was funded by grants from the National Institute of Environmental Health Sciences and the National Institute of Allergy and Infectious Diseases.

Ms. Saams said that she had no relevant financial disclosures.

SAN FRANCISCO – Parents of urban children with asthma tend to overestimate their child’s asthma control, but the factors predicting this association remain unclear, a study has shown.

"There’s a disconnect," lead investigator Joy N. Saams, R.N., said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "We tried to look for what made overestimating parents different from other parents. We had a hard time setting them apart."

In an effort to determine if parents’ perception of their child’s asthma was consistent with their child’s asthma control, Ms. Saams and her associates evaluated data from a 1-year observational study of 150 children aged 5-17 years with persistent asthma who lived in Baltimore. All children underwent spirometry. Days of symptoms and rescue medication use as well as parent/guardian perception of the child’s asthma were determined by questionnaire, said Ms. Saams of the division of pediatric allergy and immunology at Johns Hopkins University, Baltimore.

She and her associates defined misperception of asthma control as parent report of well-controlled asthma when the child’s asthma met National Asthma Education and Prevention Program criteria for disease that is not well controlled or is poorly controlled. They administered a questionnaire to determine family income, education level of the parents, and risk of depression, which was defined as scoring higher than 8 on the 10-item Center for Epidemiologic Studies Depression Scale.

The mean age of the children was 12 years, 57% were male, 91% were African American, and 53% were from households with an income of less than $25,000 per year. Nearly half of the children (43%) had asthma that was not well controlled, 32% had asthma that was poorly controlled, and 25% had asthma that was well controlled. Boys were significantly more likely than girls to have uncontrolled asthma (81% vs. 67%), Ms. Saams reported.

Parents of children with well-controlled asthma were significantly more likely to believe that their child’s asthma was well controlled, compared with parents of children with uncontrolled asthma (90% vs. 67%). "The good news may be that 90% of parents correctly identified well-controlled asthma, but 67% did not recognize uncontrolled asthma," Ms. Saams commented. "The story isn’t about who got it right, but who got it wrong."

When only reported symptoms and use of short-acting beta-agonists determined control, 62% of parents still believed that their child’s asthma was well controlled when it was not.

Although there were no statistically significant predictors of parent overestimation of asthma control, parents with less education and those with older children were more likely to overestimate their child’s asthma control, compared with parents who had higher levels of education and younger children.

There was no significant association between overestimating asthma control and increasing use of health services, but a larger percentage of children whose parents overestimated disease control had acute health care visits (56% vs. 45% among parents who did not overestimate asthma control).

The researchers concluded that parents of urban children with persistent asthma may benefit from explicit education regarding assessment of asthma control. "When you’re working with a parent and imparting education regarding asthma, pay attention to their background," Ms. Saams advised. "Are you reaching them at their level of understanding? Help them realize not only when their child’s having symptoms, but [also] that when they do have symptoms, that indicates a problem."

The study was funded by grants from the National Institute of Environmental Health Sciences and the National Institute of Allergy and Infectious Diseases.

Ms. Saams said that she had no relevant financial disclosures.

SAN FRANCISCO – Parents of urban children with asthma tend to overestimate their child’s asthma control, but the factors predicting this association remain unclear, a study has shown.

"There’s a disconnect," lead investigator Joy N. Saams, R.N., said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "We tried to look for what made overestimating parents different from other parents. We had a hard time setting them apart."

In an effort to determine if parents’ perception of their child’s asthma was consistent with their child’s asthma control, Ms. Saams and her associates evaluated data from a 1-year observational study of 150 children aged 5-17 years with persistent asthma who lived in Baltimore. All children underwent spirometry. Days of symptoms and rescue medication use as well as parent/guardian perception of the child’s asthma were determined by questionnaire, said Ms. Saams of the division of pediatric allergy and immunology at Johns Hopkins University, Baltimore.

She and her associates defined misperception of asthma control as parent report of well-controlled asthma when the child’s asthma met National Asthma Education and Prevention Program criteria for disease that is not well controlled or is poorly controlled. They administered a questionnaire to determine family income, education level of the parents, and risk of depression, which was defined as scoring higher than 8 on the 10-item Center for Epidemiologic Studies Depression Scale.

The mean age of the children was 12 years, 57% were male, 91% were African American, and 53% were from households with an income of less than $25,000 per year. Nearly half of the children (43%) had asthma that was not well controlled, 32% had asthma that was poorly controlled, and 25% had asthma that was well controlled. Boys were significantly more likely than girls to have uncontrolled asthma (81% vs. 67%), Ms. Saams reported.

Parents of children with well-controlled asthma were significantly more likely to believe that their child’s asthma was well controlled, compared with parents of children with uncontrolled asthma (90% vs. 67%). "The good news may be that 90% of parents correctly identified well-controlled asthma, but 67% did not recognize uncontrolled asthma," Ms. Saams commented. "The story isn’t about who got it right, but who got it wrong."

When only reported symptoms and use of short-acting beta-agonists determined control, 62% of parents still believed that their child’s asthma was well controlled when it was not.

Although there were no statistically significant predictors of parent overestimation of asthma control, parents with less education and those with older children were more likely to overestimate their child’s asthma control, compared with parents who had higher levels of education and younger children.

There was no significant association between overestimating asthma control and increasing use of health services, but a larger percentage of children whose parents overestimated disease control had acute health care visits (56% vs. 45% among parents who did not overestimate asthma control).

The researchers concluded that parents of urban children with persistent asthma may benefit from explicit education regarding assessment of asthma control. "When you’re working with a parent and imparting education regarding asthma, pay attention to their background," Ms. Saams advised. "Are you reaching them at their level of understanding? Help them realize not only when their child’s having symptoms, but [also] that when they do have symptoms, that indicates a problem."

The study was funded by grants from the National Institute of Environmental Health Sciences and the National Institute of Allergy and Infectious Diseases.

Ms. Saams said that she had no relevant financial disclosures.

SAN FRANCISCO – Marijuana hypersensitivity might be more common than previously thought, according to the results of a case series.

Though there are only a few case reports in the literature, "Marijuana allergy, I think, is fairly common," said lead investigator Dr. Gordon Sussman, acting division director of clinical allergy and immunology at the University of Toronto. Even so, "It's something physicians don't really generally ask about. People should consider it in the diagnosis of rhinitis [and other allergic symptoms], and even in people that have asthma and anaphylaxis."

Photo credit: ©ron hilton/iStockphoto.com

The 17 patients who were included in the series reported that marijuana gave them runny noses or other problems; all ended up having positive marijuana skin prick test results, he reported. One patient in the series had an anaphylactic reaction after drinking marijuana tea.

That was the first patient in whom Dr. Sussman diagnosed a marijuana allergy. "I asked him in a detailed history what it could have been, and he actually had drunk marijuana tea. We knew at that point he had an IgE-mediated reaction to marijuana," he said.

Curiosity piqued, and Dr. Sussman began asking allergy patients about marijuana use and reactions. A significant percentage reported symptoms from both contact and inhalation.

To confirm the diagnosis, he and his colleagues did skin-prick tests on the 17 patients between 21 and 58 years old, mostly men. They extracted buds or flowers in 5 mL of water for 15 minutes and pricked beneath drops placed on patients' skin.

After 15 minutes, the 17 patients had wheals of 4-19 mm and surrounding flares. Fifteen presented with inhalation symptoms, including rhinitis and conjunctivitis, periorbital angioedema, wheezing, sinusitis, and throat swelling. Thirteen also reported hives from contact.

The anaphylaxis patient presented with anxiety, chest tightness, wheezing, GI cramping, and vomiting after drinking the tea.

"I don't think it's a contaminant; I'm pretty sure it's an allergen in the marijuana they are reacting to," Dr. Sussman said, adding that such reactions shouldn't be a surprise because "marijuana is a weed, and weeds are generally known to be allergenic."

Asking about marijuana use and past reactions should be a routine part of allergy work-ups, especially with expanding medical marijuana use. "People could actually be sensitized to marijuana and have a serious reaction. It's important for people to recognize this," Dr. Sussman said.

The researchers' next step is to identify the actual allergens responsible for the reactions using a marijuana extract from a U.S. federal laboratory, serum from positive patients, and Western blot assays.

There was no outside funding for the study. Dr. Sussman said he had no disclosures.

SAN FRANCISCO – Marijuana hypersensitivity might be more common than previously thought, according to the results of a case series.

Though there are only a few case reports in the literature, "Marijuana allergy, I think, is fairly common," said lead investigator Dr. Gordon Sussman, acting division director of clinical allergy and immunology at the University of Toronto. Even so, "It's something physicians don't really generally ask about. People should consider it in the diagnosis of rhinitis [and other allergic symptoms], and even in people that have asthma and anaphylaxis."

Photo credit: ©ron hilton/iStockphoto.com

The 17 patients who were included in the series reported that marijuana gave them runny noses or other problems; all ended up having positive marijuana skin prick test results, he reported. One patient in the series had an anaphylactic reaction after drinking marijuana tea.

That was the first patient in whom Dr. Sussman diagnosed a marijuana allergy. "I asked him in a detailed history what it could have been, and he actually had drunk marijuana tea. We knew at that point he had an IgE-mediated reaction to marijuana," he said.

Curiosity piqued, and Dr. Sussman began asking allergy patients about marijuana use and reactions. A significant percentage reported symptoms from both contact and inhalation.

To confirm the diagnosis, he and his colleagues did skin-prick tests on the 17 patients between 21 and 58 years old, mostly men. They extracted buds or flowers in 5 mL of water for 15 minutes and pricked beneath drops placed on patients' skin.

After 15 minutes, the 17 patients had wheals of 4-19 mm and surrounding flares. Fifteen presented with inhalation symptoms, including rhinitis and conjunctivitis, periorbital angioedema, wheezing, sinusitis, and throat swelling. Thirteen also reported hives from contact.

The anaphylaxis patient presented with anxiety, chest tightness, wheezing, GI cramping, and vomiting after drinking the tea.

"I don't think it's a contaminant; I'm pretty sure it's an allergen in the marijuana they are reacting to," Dr. Sussman said, adding that such reactions shouldn't be a surprise because "marijuana is a weed, and weeds are generally known to be allergenic."

Asking about marijuana use and past reactions should be a routine part of allergy work-ups, especially with expanding medical marijuana use. "People could actually be sensitized to marijuana and have a serious reaction. It's important for people to recognize this," Dr. Sussman said.

The researchers' next step is to identify the actual allergens responsible for the reactions using a marijuana extract from a U.S. federal laboratory, serum from positive patients, and Western blot assays.

There was no outside funding for the study. Dr. Sussman said he had no disclosures.

SAN FRANCISCO – Marijuana hypersensitivity might be more common than previously thought, according to the results of a case series.

Though there are only a few case reports in the literature, "Marijuana allergy, I think, is fairly common," said lead investigator Dr. Gordon Sussman, acting division director of clinical allergy and immunology at the University of Toronto. Even so, "It's something physicians don't really generally ask about. People should consider it in the diagnosis of rhinitis [and other allergic symptoms], and even in people that have asthma and anaphylaxis."

Photo credit: ©ron hilton/iStockphoto.com

The 17 patients who were included in the series reported that marijuana gave them runny noses or other problems; all ended up having positive marijuana skin prick test results, he reported. One patient in the series had an anaphylactic reaction after drinking marijuana tea.

That was the first patient in whom Dr. Sussman diagnosed a marijuana allergy. "I asked him in a detailed history what it could have been, and he actually had drunk marijuana tea. We knew at that point he had an IgE-mediated reaction to marijuana," he said.

Curiosity piqued, and Dr. Sussman began asking allergy patients about marijuana use and reactions. A significant percentage reported symptoms from both contact and inhalation.

To confirm the diagnosis, he and his colleagues did skin-prick tests on the 17 patients between 21 and 58 years old, mostly men. They extracted buds or flowers in 5 mL of water for 15 minutes and pricked beneath drops placed on patients' skin.

After 15 minutes, the 17 patients had wheals of 4-19 mm and surrounding flares. Fifteen presented with inhalation symptoms, including rhinitis and conjunctivitis, periorbital angioedema, wheezing, sinusitis, and throat swelling. Thirteen also reported hives from contact.

The anaphylaxis patient presented with anxiety, chest tightness, wheezing, GI cramping, and vomiting after drinking the tea.

"I don't think it's a contaminant; I'm pretty sure it's an allergen in the marijuana they are reacting to," Dr. Sussman said, adding that such reactions shouldn't be a surprise because "marijuana is a weed, and weeds are generally known to be allergenic."

Asking about marijuana use and past reactions should be a routine part of allergy work-ups, especially with expanding medical marijuana use. "People could actually be sensitized to marijuana and have a serious reaction. It's important for people to recognize this," Dr. Sussman said.

The researchers' next step is to identify the actual allergens responsible for the reactions using a marijuana extract from a U.S. federal laboratory, serum from positive patients, and Western blot assays.

There was no outside funding for the study. Dr. Sussman said he had no disclosures.

SAN FRANCISCO – Marijuana hypersensitivity might be more common than previously thought, according to the results of a case series.

Though there are only a few case reports in the literature, "Marijuana allergy, I think, is fairly common," said lead investigator Dr. Gordon Sussman, acting division director of clinical allergy and immunology at the University of Toronto. Even so, "It’s something physicians don’t really generally ask about. People should consider it in the diagnosis of rhinitis [and other allergic symptoms], and even in people that have asthma and anaphylaxis."

Photo credit: ©ron hilton/iStockphoto.com

The 17 patients who were included in the series reported that marijuana gave them runny noses or other problems; all ended up having positive marijuana skin prick test results, he reported. One patient in the series had an anaphylactic reaction after drinking marijuana tea.

That was the first patient in whom Dr. Sussman diagnosed a marijuana allergy. "I asked him in a detailed history what it could have been, and he actually had drunk marijuana tea. We knew at that point he had an IgE-mediated reaction to marijuana," he said.

Curiosity piqued, and Dr. Sussman began asking allergy patients about marijuana use and reactions. A significant percentage reported symptoms from both contact and inhalation.

To confirm the diagnosis, he and his colleagues did skin-prick tests on the 17 patients between 21 and 58 years old, mostly men. They extracted buds or flowers in 5 mL of water for 15 minutes and pricked beneath drops placed on patients’ skin.

After 15 minutes, the 17 patients had wheals of 4-19 mm and surrounding flares. Fifteen presented with inhalation symptoms, including rhinitis and conjunctivitis, periorbital angioedema, wheezing, sinusitis, and throat swelling. Thirteen also reported hives from contact.

The anaphylaxis patient presented with anxiety, chest tightness, wheezing, GI cramping, and vomiting after drinking the tea.

"I don’t think it’s a contaminant; I’m pretty sure it’s an allergen in the marijuana they are reacting to," Dr. Sussman said, adding that such reactions shouldn’t be a surprise because "marijuana is a weed, and weeds are generally known to be allergenic."

Asking about marijuana use and past reactions should be a routine part of allergy work-ups, especially with expanding medical marijuana use. "People could actually be sensitized to marijuana and have a serious reaction. It’s important for people to recognize this," Dr. Sussman said.

The researchers’ next step is to identify the actual allergens responsible for the reactions using a marijuana extract from a U.S. federal laboratory, serum from positive patients, and Western blot assays.

There was no outside funding for the study. Dr. Sussman said he had no disclosures.

SAN FRANCISCO – Marijuana hypersensitivity might be more common than previously thought, according to the results of a case series.

Though there are only a few case reports in the literature, "Marijuana allergy, I think, is fairly common," said lead investigator Dr. Gordon Sussman, acting division director of clinical allergy and immunology at the University of Toronto. Even so, "It’s something physicians don’t really generally ask about. People should consider it in the diagnosis of rhinitis [and other allergic symptoms], and even in people that have asthma and anaphylaxis."

Photo credit: ©ron hilton/iStockphoto.com

The 17 patients who were included in the series reported that marijuana gave them runny noses or other problems; all ended up having positive marijuana skin prick test results, he reported. One patient in the series had an anaphylactic reaction after drinking marijuana tea.

That was the first patient in whom Dr. Sussman diagnosed a marijuana allergy. "I asked him in a detailed history what it could have been, and he actually had drunk marijuana tea. We knew at that point he had an IgE-mediated reaction to marijuana," he said.

Curiosity piqued, and Dr. Sussman began asking allergy patients about marijuana use and reactions. A significant percentage reported symptoms from both contact and inhalation.

To confirm the diagnosis, he and his colleagues did skin-prick tests on the 17 patients between 21 and 58 years old, mostly men. They extracted buds or flowers in 5 mL of water for 15 minutes and pricked beneath drops placed on patients’ skin.

After 15 minutes, the 17 patients had wheals of 4-19 mm and surrounding flares. Fifteen presented with inhalation symptoms, including rhinitis and conjunctivitis, periorbital angioedema, wheezing, sinusitis, and throat swelling. Thirteen also reported hives from contact.

The anaphylaxis patient presented with anxiety, chest tightness, wheezing, GI cramping, and vomiting after drinking the tea.

"I don’t think it’s a contaminant; I’m pretty sure it’s an allergen in the marijuana they are reacting to," Dr. Sussman said, adding that such reactions shouldn’t be a surprise because "marijuana is a weed, and weeds are generally known to be allergenic."

Asking about marijuana use and past reactions should be a routine part of allergy work-ups, especially with expanding medical marijuana use. "People could actually be sensitized to marijuana and have a serious reaction. It’s important for people to recognize this," Dr. Sussman said.

The researchers’ next step is to identify the actual allergens responsible for the reactions using a marijuana extract from a U.S. federal laboratory, serum from positive patients, and Western blot assays.

There was no outside funding for the study. Dr. Sussman said he had no disclosures.

SAN FRANCISCO – Marijuana hypersensitivity might be more common than previously thought, according to the results of a case series.

Though there are only a few case reports in the literature, "Marijuana allergy, I think, is fairly common," said lead investigator Dr. Gordon Sussman, acting division director of clinical allergy and immunology at the University of Toronto. Even so, "It’s something physicians don’t really generally ask about. People should consider it in the diagnosis of rhinitis [and other allergic symptoms], and even in people that have asthma and anaphylaxis."

Photo credit: ©ron hilton/iStockphoto.com

The 17 patients who were included in the series reported that marijuana gave them runny noses or other problems; all ended up having positive marijuana skin prick test results, he reported. One patient in the series had an anaphylactic reaction after drinking marijuana tea.

That was the first patient in whom Dr. Sussman diagnosed a marijuana allergy. "I asked him in a detailed history what it could have been, and he actually had drunk marijuana tea. We knew at that point he had an IgE-mediated reaction to marijuana," he said.

Curiosity piqued, and Dr. Sussman began asking allergy patients about marijuana use and reactions. A significant percentage reported symptoms from both contact and inhalation.

To confirm the diagnosis, he and his colleagues did skin-prick tests on the 17 patients between 21 and 58 years old, mostly men. They extracted buds or flowers in 5 mL of water for 15 minutes and pricked beneath drops placed on patients’ skin.

After 15 minutes, the 17 patients had wheals of 4-19 mm and surrounding flares. Fifteen presented with inhalation symptoms, including rhinitis and conjunctivitis, periorbital angioedema, wheezing, sinusitis, and throat swelling. Thirteen also reported hives from contact.

The anaphylaxis patient presented with anxiety, chest tightness, wheezing, GI cramping, and vomiting after drinking the tea.

"I don’t think it’s a contaminant; I’m pretty sure it’s an allergen in the marijuana they are reacting to," Dr. Sussman said, adding that such reactions shouldn’t be a surprise because "marijuana is a weed, and weeds are generally known to be allergenic."

Asking about marijuana use and past reactions should be a routine part of allergy work-ups, especially with expanding medical marijuana use. "People could actually be sensitized to marijuana and have a serious reaction. It’s important for people to recognize this," Dr. Sussman said.

The researchers’ next step is to identify the actual allergens responsible for the reactions using a marijuana extract from a U.S. federal laboratory, serum from positive patients, and Western blot assays.

There was no outside funding for the study. Dr. Sussman said he had no disclosures.

SAN FRANCISCO – Marijuana hypersensitivity might be more common than previously thought, according to the results of a case series.

Though there are only a few case reports in the literature, "Marijuana allergy, I think, is fairly common," said lead investigator Dr. Gordon Sussman, acting division director of clinical allergy and immunology at the University of Toronto. Even so, "It’s something physicians don’t really generally ask about. People should consider it in the diagnosis of rhinitis [and other allergic symptoms], and even in people that have asthma and anaphylaxis."

Photo credit: ©ron hilton/iStockphoto.com

The 17 patients who were included in the series reported that marijuana gave them runny noses or other problems; all ended up having positive marijuana skin prick test results, he reported. One patient in the series had an anaphylactic reaction after drinking marijuana tea.

That was the first patient in whom Dr. Sussman diagnosed a marijuana allergy. "I asked him in a detailed history what it could have been, and he actually had drunk marijuana tea. We knew at that point he had an IgE-mediated reaction to marijuana," he said.

Curiosity piqued, and Dr. Sussman began asking allergy patients about marijuana use and reactions. A significant percentage reported symptoms from both contact and inhalation.

To confirm the diagnosis, he and his colleagues did skin-prick tests on the 17 patients between 21 and 58 years old, mostly men. They extracted buds or flowers in 5 mL of water for 15 minutes and pricked beneath drops placed on patients’ skin.

After 15 minutes, the 17 patients had wheals of 4-19 mm and surrounding flares. Fifteen presented with inhalation symptoms, including rhinitis and conjunctivitis, periorbital angioedema, wheezing, sinusitis, and throat swelling. Thirteen also reported hives from contact.

The anaphylaxis patient presented with anxiety, chest tightness, wheezing, GI cramping, and vomiting after drinking the tea.

"I don’t think it’s a contaminant; I’m pretty sure it’s an allergen in the marijuana they are reacting to," Dr. Sussman said, adding that such reactions shouldn’t be a surprise because "marijuana is a weed, and weeds are generally known to be allergenic."

Asking about marijuana use and past reactions should be a routine part of allergy work-ups, especially with expanding medical marijuana use. "People could actually be sensitized to marijuana and have a serious reaction. It’s important for people to recognize this," Dr. Sussman said.

The researchers’ next step is to identify the actual allergens responsible for the reactions using a marijuana extract from a U.S. federal laboratory, serum from positive patients, and Western blot assays.

There was no outside funding for the study. Dr. Sussman said he had no disclosures.

SAN FRANCISCO – Marijuana hypersensitivity might be more common than previously thought, according to the results of a case series.

Though there are only a few case reports in the literature, "Marijuana allergy, I think, is fairly common," said lead investigator Dr. Gordon Sussman, acting division director of clinical allergy and immunology at the University of Toronto. Even so, "It’s something physicians don’t really generally ask about. People should consider it in the diagnosis of rhinitis [and other allergic symptoms], and even in people that have asthma and anaphylaxis."

Photo credit: ©ron hilton/iStockphoto.com

The 17 patients who were included in the series reported that marijuana gave them runny noses or other problems; all ended up having positive marijuana skin prick test results, he reported. One patient in the series had an anaphylactic reaction after drinking marijuana tea.

That was the first patient in whom Dr. Sussman diagnosed a marijuana allergy. "I asked him in a detailed history what it could have been, and he actually had drunk marijuana tea. We knew at that point he had an IgE-mediated reaction to marijuana," he said.

Curiosity piqued, and Dr. Sussman began asking allergy patients about marijuana use and reactions. A significant percentage reported symptoms from both contact and inhalation.

To confirm the diagnosis, he and his colleagues did skin-prick tests on the 17 patients between 21 and 58 years old, mostly men. They extracted buds or flowers in 5 mL of water for 15 minutes and pricked beneath drops placed on patients’ skin.

After 15 minutes, the 17 patients had wheals of 4-19 mm and surrounding flares. Fifteen presented with inhalation symptoms, including rhinitis and conjunctivitis, periorbital angioedema, wheezing, sinusitis, and throat swelling. Thirteen also reported hives from contact.

The anaphylaxis patient presented with anxiety, chest tightness, wheezing, GI cramping, and vomiting after drinking the tea.

"I don’t think it’s a contaminant; I’m pretty sure it’s an allergen in the marijuana they are reacting to," Dr. Sussman said, adding that such reactions shouldn’t be a surprise because "marijuana is a weed, and weeds are generally known to be allergenic."

Asking about marijuana use and past reactions should be a routine part of allergy work-ups, especially with expanding medical marijuana use. "People could actually be sensitized to marijuana and have a serious reaction. It’s important for people to recognize this," Dr. Sussman said.

The researchers’ next step is to identify the actual allergens responsible for the reactions using a marijuana extract from a U.S. federal laboratory, serum from positive patients, and Western blot assays.

There was no outside funding for the study. Dr. Sussman said he had no disclosures.

SAN FRANCISCO – Marijuana hypersensitivity might be more common than previously thought, according to the results of a case series.

Though there are only a few case reports in the literature, "Marijuana allergy, I think, is fairly common," said lead investigator Dr. Gordon Sussman, acting division director of clinical allergy and immunology at the University of Toronto. Even so, "It’s something physicians don’t really generally ask about. People should consider it in the diagnosis of rhinitis [and other allergic symptoms], and even in people that have asthma and anaphylaxis."

Photo credit: ©ron hilton/iStockphoto.com

The 17 patients who were included in the series reported that marijuana gave them runny noses or other problems; all ended up having positive marijuana skin prick test results, he reported. One patient in the series had an anaphylactic reaction after drinking marijuana tea.

That was the first patient in whom Dr. Sussman diagnosed a marijuana allergy. "I asked him in a detailed history what it could have been, and he actually had drunk marijuana tea. We knew at that point he had an IgE-mediated reaction to marijuana," he said.

Curiosity piqued, and Dr. Sussman began asking allergy patients about marijuana use and reactions. A significant percentage reported symptoms from both contact and inhalation.

To confirm the diagnosis, he and his colleagues did skin-prick tests on the 17 patients between 21 and 58 years old, mostly men. They extracted buds or flowers in 5 mL of water for 15 minutes and pricked beneath drops placed on patients’ skin.

After 15 minutes, the 17 patients had wheals of 4-19 mm and surrounding flares. Fifteen presented with inhalation symptoms, including rhinitis and conjunctivitis, periorbital angioedema, wheezing, sinusitis, and throat swelling. Thirteen also reported hives from contact.

The anaphylaxis patient presented with anxiety, chest tightness, wheezing, GI cramping, and vomiting after drinking the tea.

"I don’t think it’s a contaminant; I’m pretty sure it’s an allergen in the marijuana they are reacting to," Dr. Sussman said, adding that such reactions shouldn’t be a surprise because "marijuana is a weed, and weeds are generally known to be allergenic."

Asking about marijuana use and past reactions should be a routine part of allergy work-ups, especially with expanding medical marijuana use. "People could actually be sensitized to marijuana and have a serious reaction. It’s important for people to recognize this," Dr. Sussman said.

The researchers’ next step is to identify the actual allergens responsible for the reactions using a marijuana extract from a U.S. federal laboratory, serum from positive patients, and Western blot assays.

There was no outside funding for the study. Dr. Sussman said he had no disclosures.

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.