2. Goubrad Botros H, Poncet P, Rabillon J, Fontaine T, Laval JM, David B. Bio- chemical characterization and surfactant properties of horse allergens. Eur J Bio- chem 2001;268:3126–3136. 3. Gregoire C, Rosinski-Chupin I, Rabillon J, Alzari PM, David B, Dandeu JP. cDNA cloning and sequencing reveal the major horse allergen Ecu c1 to be a glycoprotein member of the lipocalin Superfamily. J Biological Chemistry 1996;271: 32951–32959. 4. Bulone V, Krogstad-Johnsen T, Smestad- Paulsen B. Separation of horse dander allergen proteins by two-dimensional elec- trophoresis. Molecular characterization and identification of Equ c2.22101 and Equ c2.0102. Eur J Biochem 1998;253:202–211. 5. Dandeu JP, Rabillon J, Divanovic A, Carmı`-Leroy A, David B. Hydrophobic interaction chromatography for isolation and purification of Equ c1, the horse major allergen. J Chromatography 1993;621: 23–31. 6. Virtanen T. Lipocalin allergens. Allergy 2001;56(Suppl 67):48–51. The place of spirometry in the diagnosis of asthma in those suffering from allergic rhinitis: a pilot study P. Demoly*, R. Gauchoux, P. Morera, D. Touron, J.-P. Daures Key words: Asthma; diagnosis; rhinitis; self-questionnaire; spirometry. Since many epidemiological studies have shown that asthma and rhinitis co-exist frequently, it would appear to be essential to search for asthma in patients suf- fering from allergic rhini- tis (1–3). General prac- titioners and ENT special- ists who do not possess suitable equip- ment for measuring pulmonary function see the majority of patients affected. The aim of this study was to determine the place of spirometry in the diagnosis of asthma in patients diagnosed with rhinitis and allergy. To set the diagnosis of asthma in rhinitic patients, we built up an algorithm combining the results of a self-adminis- tered questionnaire and pulmonary function tests. We utilized the validated questionnaire of Venables et al. (4). It has nine questions which assess the last 4 weeks for the presence or absence of asthma symptoms (cough, wheeze, chest tightness, difficulty with breathing) at different periods of time and in different situations (e.g. running or climbing stairs at speed, sleeping, in the morning, whilst in a smoky room or dusty place). Whe- ther asthma was indeed suspected or not at this stage depended on the number of positive responses (probable nonasth- matic: 1–2, possible asthma: 3–4, prob- able asthma: 5–8). Patients with nine positive responses were considered as asthmatics. The first 2–4 patients diag- nosed with rhinitis (showing two of three symptoms: sneezing/nasal itching – nasal obstruction – rhinorrhea for at least 2 years at the same time of the year) and allergy (confirmed within the last 2 years by skin tests and/or IgE positive to the common air-borne allergens of our area) who consulted either GPs or ENT spe- cialists were included. Patients with known asthma, smoking more than five pack-year or any severe concomitant disease were excluded. Patients with at least one positive question were invited to our allergy department. These tests included: peak expiratory flow (PEF), FEV1 measurements and, depending on the FEV1 results, a reversibility test to beta-mimetics or the methacholine chal- lenge test. The algorithm (Figure 1) combining the results of the self-ques- tionnaire and the pulmonary function tests led to the final diagnosis and permitted patients to be classified as asthmatics (A) or nonasthmatics (NA). The ethical committee of Montpellier approved this study and all patients signed an informed consent. ROC curves expressed as the area under the curve (AUC ± SD) were util- ized to assess the place of each measure- ment in the diagnosis of asthma. Twenty-six patients (M/F: 11/15; 36.2 ± 13.1 years) were enrolled by six general practitioners and five ENT doc- tors during spring 2002. Patients were divided into six probable NA, 12 possible A and eight probable A in response to the self-questionnaire and 19 NA and seven A after the complete procedure (Figure 1). There was a correlation be- tween the self-questionnaire results and the final diagnosis, with no A amongst the probable NA and possible A from the self-questionnaire, and seven A among the eight probable A. All asthmatics had a score higher than five on the self- questionnaire and all but one nonasth- matic had a score lower than 5. When ROC curves were performed and com- pared with the AUC of the self-ques- tionnaire (AUC ¼ 0.962 ± 0.450), pulmonary function tests added little (P > 0.05). The self-questionnaire was capable of discriminating asthma without false A self-questionnaire was capable of diagnosing asthma in allergic rhinitis patients better than spirometry. Figure 1. Algorithm of asthma diagnosis. 1089 ALLERGY Net