Yıl: 2021 Cilt: 51 Sayı: 5 Sayfa Aralığı: 2631 - 2640 Metin Dili: İngilizce DOI: :10.3906/sag-2104-55 İndeks Tarihi: 10-01-2022

Allergic diseases in the elderly population: a single-center experience

Öz:
Background/aim: Although allergic diseases are generally considered to be diseases of childhood and youth, the first symptoms of allergic diseases can be seen in old age sometimes. The aim of this study was to determine the prevalence and characteristics of allergic diseases in the elderly population admitted to the allergy unit on an outpatient basis. Materials and methods: The files of the patients who applied to our clinic’s allergy unit during the 8-year period were retrospectively analyzed. The data of patients aged ≥ 65 years were obtained from the files of our allergy unit archive. Results: A total of 1272 patients aged ≥ 65 years old were included in the study. The mean age was 70 years (range: 65–97 years). Most of the patients were female (n = 704, 55.3%). Of the patients, 887 (69.8%) presented with cutaneous symptoms, and urticaria was identified in 500 of them (56.3%). Drug hypersensitivity reactions were detected in 175 (13.7%) patients. A total of 71 (5.6%) patients had asthma, 65 (5.1%) had anaphylaxis, 48 (3.8%) had allergic rhinitis, 24 (1.9%) had hymenoptera venom allergy, and 18 (1.4%) had food allergies. Atopy history (OR = 2.323, 95% CI = 1.590–3.393, p < 0.001) and comorbidity (OR = 1.631, 95% CI = 1.050–2.533, p = 0.029) were found to be risk factors for drug hypersensitivity reactions. Male sex (OR = 3.462, 95% CI = 1.097–10.933, p = 0.034) and atopy history (OR = 14.877, 95% CI = 6.081–36.393, p < 0.001) were found to be risk factors for hymenoptera venom allergy. Conclusion: Diagnosis becomes difficult due to the perception that allergic diseases mainly affect young people. Clinical symptoms are not evident in the elderly and age-related difficulties are encountered in diagnostic tests. There is a need to develop specific guidelines for the diagnosis of allergic diseases in the elderly.Key words: Elderly, allergic diseases, allergic rhinitis, drug hypersensitivity reactions, hymenoptera venom allergy, anaphylaxis
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  • 1. Ventura MT, D’Amato A, Giannini M, Carretta A, Tummolo RA et al. Incidence of allergic diseases in an elderly population. Immunopharmacology and Immunotoxicology. 2010; 32 (1): 165-170. doi: 10.3109/08923970903213735
  • 2. Cardona V, Guilarte M, Luengo O, Labrador-Horrillo M, SalaCunill A et al. Allergic diseases in the elderly. Clinical and Translational Allergy. 2011; 1 (1): 11. doi: 10.1186/2045-7022- 1-11
  • 3. Montanaro A. Allergic disease management in the elderly: a wakeup call for the allergy community. Annals of Allergy, Asthma and Immunology. 2000; 85 (2): 85-86. doi: 10.1016/ S1081-1206(10)62442-8
  • 4. Sahin-Yilmaz AA, Corey JP. Rhinitis in the elderly. Clinical Allergy and Immunology. 2007; 19: 209-219.
  • 5. Dykewicz MS, Lam JK. Drug Hypersensitivity Reactions. Medical Clinics of North America. 2020; 104 (1): 109-128. doi: 10.1016/j.mcna.2019.09.003
  • 6. Cardona V, Ansotegui IJ, Ebisawa M, El-Gamal Y, Fernandez Rivas M et al. World allergy organization anaphylaxis guidance 2020. World Allergy Organization Journal. 2020; 13 (10): 100472. doi: 10.1016/j.waojou.2020.100472
  • 7. Grabenhenrich LB, Dolle S, Moneret-Vautrin A, Kohli A, Lange L et al. Anaphylaxis in children and adolescents: The European Anaphylaxis Registry. Journal of Allergy and Clinical Immunology. 2016; 137 (4): 1128-1137 e1. doi: 10.1016/j. jaci.2015.11.015
  • 8. Leus AJG, Meijer JM, Zuidema SU, Jonkman MF. [Pruritus in elderly: diagnosis and treatment]. Nederlands Tijdschrift voor Geneeskunde. 2018; 163.
  • 9. Ban GY, Kim MY, Yoo HS, Nahm DH, Ye YM et al. Clinical features of elderly chronic urticaria. The Korean Journal of Internal Medicine. 2014; 29 (6): 800-806. doi: 10.3904/ kjim.2014.29.6.800
  • 10. Agostoni A, Cicardi M. Drug-induced angioedema without urticaria. Drug Safety. 2001; 24 (8): 599-606. doi: 10.2165/00002018-200124080-00004
  • 11. Madsen F, Attermann J, Linneberg A. Epidemiology of nonhereditary angioedema. Acta Dermato-Venereologica. 2012; 92 (5): 475-479. doi: 10.2340/00015555-1389
  • 12. Vasekar M, Craig TJ. ACE inhibitor-induced angioedema. Current Allergy and Asthma Reports. 2012; 12 (1): 72-78. doi: 10.1007/s11882-011-0238-z
  • 13. Kostis JB, Kim HJ, Rusnak J, Casale T, Kaplan A et al. Incidence and characteristics of angioedema associated with enalapril. Archives of Internal Medicine. 2005; 165 (14): 1637-1642. doi: 10.1001/archinte.165.14.1637
  • 14. Lefebvre J, Murphey LJ, Hartert TV, Jiao Shan R, Simmons WH et al. Dipeptidyl peptidase IV activity in patients with ACEinhibitor-associated angioedema. Hypertension. 2002; 39 (2 Pt 2): 460-464. doi: 10.1161/hy0202.103054
  • 15 Barbarot S, Auziere S, Gadkari A, Girolomoni G, Puig L et al. Epidemiology of atopic dermatitis in adults: Results from an international survey. Allergy. 2018; 73 (6): 1284-1293. doi: 10.1111/all.13401
  • 16. Lima AL, Timmermann V, Illing T, Elsner P. Contact Dermatitis in the Elderly: Predisposing Factors, Diagnosis, and Management. Drugs Aging. 2019; 36 (5): 411-417. doi: 10.1007/ s40266-019-00641-4
  • 17. Balato A, Balato N, Di Costanzo L, Ayala F. Contact sensitization in the elderly. Clinics in Dermatology. 2011; 29 (1): 24-30. doi: 10.1016/j.clindermatol.2010.07.003
  • 18. Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM et al. International Consensus on drug allergy. Allergy. 2014; 69 (4): 420-437. doi: 10.1111/all.12350
  • 19. Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ et al. Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. Journal of Allergy and Clinical Immunology. 2004; 113 (5): 832-836. doi: 10.1016/j. jaci.2003.12.591
  • 20. Davies EA, O’Mahony MS. Adverse drug reactions in special populations - the elderly. British Journal of Clinical Pharmacology. 2015; 80 (4): 796-807. doi: 10.1111/bcp.12596
  • 21. Brozek JL, Bousquet J, Agache I, Agarwal A, Bachert C et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision. Journal of Allergy and Clinical Immunology. 2017; 140 (4): 950-958. doi: 10.1016/j. jaci.2017.03.050
  • 22. Bousquet J, Van Cauwenberge P, Khaltaev N, Aria Workshop G, World Health O. Allergic rhinitis and its impact on asthma. Journal of Allergy and Clinical Immunology. 2001; 108 (5 Suppl): S147-334. doi: 10.1067/mai.2001.118891
  • 23. Baptist AP, Nyenhuis S. Rhinitis in the Elderly. Immunology and Allergy Clinics of North America. 2016; 36 (2): 343-357. doi: 10.1016/j.iac.2015.12.010
  • 24. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008; 63 Suppl 86: 8-160. doi: 10.1111/j.1398-9995.2007.01620.x
  • 25. Kalpaklioglu AF, Kavut AB. Allergic and nonallergic rhinitis: can we find the differences/similarities between the two pictures? Journal of Asthma. 2009; 46 (5): 481-485. doi: 10.1080/02770900902849897
  • 26. Khan DA. Allergic rhinitis and asthma: epidemiology and common pathophysiology. Allergy and Asthma Proceedings. 2014; 35 (5): 357-361. doi: 10.2500/aap.2014.35.3794
  • 27. Dunn RM, Busse PJ, Wechsler ME. Asthma in the elderly and late-onset adult asthma. Allergy. 2018; 73 (2): 284-294. doi: 10.1111/all.13258
  • 28. Scichilone N, Pedone C, Battaglia S, Sorino C, Bellia V. Diagnosis and management of asthma in the elderly. European Journal of Internal Medicine. 2014; 25 (4): 336-342. doi: 10.1016/j.ejim.2014.01.004
  • 29. Madeo J, Li Z, Frieri M. Asthma in the geriatric population. Allergy and Asthma Proceedings. 2013; 34 (5): 427-433. doi: 10.2500/aap.2013.34.3687
  • 30. Sturm GJ, Varga EM, Roberts G, Mosbech H, Bilo MB et al. EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy. Allergy. 2018; 73 (4): 744-764. doi: 10.1111/ all.13262
  • 31. Gelincik A, Issever H, Unal D, Isik E, Demirturk M et al. The prevalence of Hymenoptera venom allergy in adults: the results of a very crowded city in Euroasia. Allergology International. 2015; 64 (1): 35-40. doi: 10.1016/j.alit.2014.10.001
  • 32. Bonadonna P, Perbellini O, Passalacqua G, Caruso B, Colarossi S et al. Clonal mast cell disorders in patients with systemic reactions to Hymenoptera stings and increased serum tryptase levels. Journal of Allergy and Clinical Immunology. 2009; 123 (3): 680-686. doi: 10.1016/j.jaci.2008.11.018
  • 33. Rueff F, Placzek M, Przybilla B. Mastocytosis and Hymenoptera venom allergy. Current Opinion in Allergy and Clinical Immunology. 2006; 6 (4): 284-288. doi: 10.1097/01. all.0000235903.10548.63
  • 34. Ludolph-Hauser D, Rueff F, Fries C, Schopf P, Przybilla B. Constitutively raised serum concentrations of mast-cell tryptase and severe anaphylactic reactions to Hymenoptera stings. Lancet. 2001; 357 (9253): 361-362. doi: 10.1016/S0140- 6736(00)03647-3
  • 35. Iweala OI, Choudhary SK, Commins SP. Food Allergy. Current Gastroenterology Reports. 2018; 20 (5): 17. doi: 10.1007/ s11894-018-0624-y
  • 36. Campbell RL, Hagan JB, Li JT, Vukov SC, Kanthala AR et al. Anaphylaxis in emergency department patients 50 or 65 years or older. Annals of Allergy, Asthma and Immunology. 2011; 106 (5): 401-406. doi: 10.1016/j.anai.2011.01.011
  • 37. Scichilone N, Callari A, Augugliaro G, Marchese M, Togias A et al. The impact of age on prevalence of positive skin prick tests and specific IgE tests. Respiratory Medicine. 2011; 105 (5): 651-658. doi: 10.1016/j.rmed.2010.12.014
  • 38. King MJ, Lockey RF. Allergen prick-puncture skin testing in the elderly. Drugs Aging. 2003; 20 (14): 1011-1017. doi: 10.2165/00002512-200320140-00001
APA YILDIZ E, ÇÖLKESEN F, Arslan S, EVCEN R, Sadi Aykan F, Kılınç M, Aytekin G (2021). Allergic diseases in the elderly population: a single-center experience. , 2631 - 2640. :10.3906/sag-2104-55
Chicago YILDIZ ERAY,ÇÖLKESEN FATİH,Arslan Sevket,EVCEN RECEP,Sadi Aykan Filiz,Kılınç Mehmet,Aytekin Gökhan Allergic diseases in the elderly population: a single-center experience. (2021): 2631 - 2640. :10.3906/sag-2104-55
MLA YILDIZ ERAY,ÇÖLKESEN FATİH,Arslan Sevket,EVCEN RECEP,Sadi Aykan Filiz,Kılınç Mehmet,Aytekin Gökhan Allergic diseases in the elderly population: a single-center experience. , 2021, ss.2631 - 2640. :10.3906/sag-2104-55
AMA YILDIZ E,ÇÖLKESEN F,Arslan S,EVCEN R,Sadi Aykan F,Kılınç M,Aytekin G Allergic diseases in the elderly population: a single-center experience. . 2021; 2631 - 2640. :10.3906/sag-2104-55
Vancouver YILDIZ E,ÇÖLKESEN F,Arslan S,EVCEN R,Sadi Aykan F,Kılınç M,Aytekin G Allergic diseases in the elderly population: a single-center experience. . 2021; 2631 - 2640. :10.3906/sag-2104-55
IEEE YILDIZ E,ÇÖLKESEN F,Arslan S,EVCEN R,Sadi Aykan F,Kılınç M,Aytekin G "Allergic diseases in the elderly population: a single-center experience." , ss.2631 - 2640, 2021. :10.3906/sag-2104-55
ISNAD YILDIZ, ERAY vd. "Allergic diseases in the elderly population: a single-center experience". (2021), 2631-2640. https://doi.org/:10.3906/sag-2104-55
APA YILDIZ E, ÇÖLKESEN F, Arslan S, EVCEN R, Sadi Aykan F, Kılınç M, Aytekin G (2021). Allergic diseases in the elderly population: a single-center experience. Turkish Journal of Medical Sciences, 51(5), 2631 - 2640. :10.3906/sag-2104-55
Chicago YILDIZ ERAY,ÇÖLKESEN FATİH,Arslan Sevket,EVCEN RECEP,Sadi Aykan Filiz,Kılınç Mehmet,Aytekin Gökhan Allergic diseases in the elderly population: a single-center experience. Turkish Journal of Medical Sciences 51, no.5 (2021): 2631 - 2640. :10.3906/sag-2104-55
MLA YILDIZ ERAY,ÇÖLKESEN FATİH,Arslan Sevket,EVCEN RECEP,Sadi Aykan Filiz,Kılınç Mehmet,Aytekin Gökhan Allergic diseases in the elderly population: a single-center experience. Turkish Journal of Medical Sciences, vol.51, no.5, 2021, ss.2631 - 2640. :10.3906/sag-2104-55
AMA YILDIZ E,ÇÖLKESEN F,Arslan S,EVCEN R,Sadi Aykan F,Kılınç M,Aytekin G Allergic diseases in the elderly population: a single-center experience. Turkish Journal of Medical Sciences. 2021; 51(5): 2631 - 2640. :10.3906/sag-2104-55
Vancouver YILDIZ E,ÇÖLKESEN F,Arslan S,EVCEN R,Sadi Aykan F,Kılınç M,Aytekin G Allergic diseases in the elderly population: a single-center experience. Turkish Journal of Medical Sciences. 2021; 51(5): 2631 - 2640. :10.3906/sag-2104-55
IEEE YILDIZ E,ÇÖLKESEN F,Arslan S,EVCEN R,Sadi Aykan F,Kılınç M,Aytekin G "Allergic diseases in the elderly population: a single-center experience." Turkish Journal of Medical Sciences, 51, ss.2631 - 2640, 2021. :10.3906/sag-2104-55
ISNAD YILDIZ, ERAY vd. "Allergic diseases in the elderly population: a single-center experience". Turkish Journal of Medical Sciences 51/5 (2021), 2631-2640. https://doi.org/:10.3906/sag-2104-55