Effect of traffic pollution on asthma and a challenging clinical case

May 29, 2018

As the beginning of summer approaches and May draws to a close, I hope you have had time to read various articles in the pages of the Annals of Allergy, Asthma and Immunology. I would like to call your attention to some features of our journal not regularly commented on in this column.

The first is our Perspectives feature. The purpose of this type of article is to provide an evidence-based “opinion” from acknowledged experts in our field. These articles are often controversial and almost always provocative in terms of addressing issues about which people have differing opinions or perspectives. One such article is by Yoomie J. Lee, MD and Nathan Rabinovitch, MD, MPH who address, in a very thought-provoking way, whether exposure to traffic pollution particles and asthma activity is a “cause-and effect” or merely a statistical correlation derived from population-based studies with little applicability to patients. Using the ‘Hill criteria’ as a basis, they offer a rather interesting perspective that readers will want to thoughtfully consider.

Another is Challenging Clinical Cases where a difficult or unusual presentation of an illness we care for is presented and the logic used to make the final diagnosis is discussed. This installment, written by Barbara Brunet, MD, Rebecca Sugg, MD, and Patricia Stewart, MD, FACAAI, reports on an elderly individual who presented with diffuse neurological symptoms and was hospitalized. Historical review indicated he had been started on omalizumab two months earlier for asthma and nasal polyposis. At that time his eosinophil count was 2,300 with no neurological symptoms. A well described workup was performed, and the diagnosis of hypereosinophilic syndrome was ultimately made. This article describes the clinical logic used to arrive at this diagnosis.

We do appreciate all feedback received and use it to continue to work to make Annals better next month than it was this month. Your comments, both pro and con, are very useful to us. Feel free to contact me at gmarshall@umc.edu. Look for your June issue coming soon.

Gailen D. Marshall, Jr., MD PhD FACAAI