Steroid Exposure Risk High in 'Allergic Triad'
18.05.12
ORLANDO Children who have at least two diagnoses of the "allergic triad" asthma, allergic rhinitis, and atopic dermatitis often receive prescriptions from multiple physicians and may be at risk for substantial exposure to exogenous corticosteroids.
This finding, from a chart review of 197 pediatric patients seen between 2000 and 2010 at a single U.S. allergy/immunology clinic, "reinforces the need for improved communication and coordination of care," said Dr. Min Jung Lee of Cohen Childrens Medical Center of New York.
Of the 197 patients who had been diagnosed with at least two of the three ICD-9 codes for asthma, allergic rhinitis, and/or atopic dermatitis, 48% had all three conditions. Of the patients diagnosed with two of the three conditions, 67% had both asthma and allergic rhinitis, 16.5% had asthma and atopic dermatitis, and 16.5% had allergic rhinitis and atopic dermatitis, Dr. Lee said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.
Source: Family Practice News Digital Network
Angioedema Hospitalizations Rising, Especially in African Americans
18.05.12
Angiotensin-converting enzyme (ACE) inhibitors are the drugs most responsible for causing angioedema, and it seems this drug class is especially responsible for the rapid increase in the number of angioedema cases among African Americans, he said.
Among African Americans, hospitalizations for angioedema jumped from 9 cases per 100,000 in 2000 to 18 cases per 100,000 in 2009. In contrast, among nonAfrican American residents of the United States, hospitalizations for angioedema rose from 2.7 cases per 100,000 in 2000 to 3.6 cases per 100,000 in 2009(see table).
African Americans seem particularly susceptible to developing angioedema triggered by ACE inhibitors, noted Dr. Lin. In addition, diseases that often lead to treatment with an ACE inhibitor, such as hypertension, chronic kidney disease, and heart failure, are especially prevalent among African Americans.
Angiotensin-receptor blockers, which are not linked to causing angioedema, might be a better alternative for African American patients, said Dr. Lin, a professor of medicine at New York Medical College and chief of the division of allergy and immunology at New York Downtown Hospital.
Source: Family Practice News Digital Network