High frequency of atopic asthma in a pulmonary clinic population

Seventy-two consecutive adult asthmatic patients seen in the Pulmonary Clinic at Rhode Island Hospital were tested for atopy by prick test with 14 standard aeroallergens and by in vitro total and specific IgE determinations (FAST). A total of 58.3 percent of patients were found to be atopic by these tests. There was a significant difference between the mean total serum IgE in atopic and nonatopic asthma and in atopic asthma and control subjects. The age onset was lower in atopic asthmatic patients, and they were more likely to have a history of chronic rhinitis than nonatopic subjects. Family history of rhinitis or asthma and severity of asthma was not different between the two groups. Since our outpatient facility has a large allergy clinic in proximity to the pulmonary clinic, which was the source of our patient population, this investigation has a negative bias toward allergy. Nevertheless, this study reveals that atopy is common in adult asthmatic patients, and a battery of allergy tests (skin tests or in vitro tests) together with total serum IgE is able to differentiate between atopic and nonatopic asthma.