Dominant Aero-Allergens Involved in Causing Allergic Rhinitis with Special Reference to Dust Mite Allergy and Skin Prick Test in Tripura: A Prospective Study.

Abstract

Allergic rhinitis (AR) is one of the commonest forms of allergy in the world which causes significant morbidity. The prevalence has all the more increased because of increasing air pollution. Though skin prick testing (SPT) and sublingual immunotherapy (SLIT) have now been widely accepted world wide as important tool, offering prospective long term remission or cure for allergic rhinitis yet some still debate the accuracy and efficacy of both. This prospective study was conducted from February 2018 to May 2020, from amongst the patients of allergic rhinitis, presenting to the author in his private clinic. There were total 37 patients who presented with symptoms suggestive of allergic rhinitis and who underwent SPT for various common aeroallergens, as suggested by their history. The age range of the patients was from 6 to 60years, with a mean age of 27.62years. There were 23 male and 14 female patients with a male to female ratio of 1.76:1. The commonest age group affected is 21-30year group. Out of the total 37 patients of allergic rhinitis, who underwent SPT, 32 (86.5%) had a positive response and 05 (13.5%) patients had a negative response. Out of the 32 patients with positive response, 30 (93.8%) had positive reactions to multiple allergens and just 2 (6.2%) had positive reaction to single allergen. The commonest aeroallergen detected by SPT was house dust mite (bed mite) Dermatophagoides ( D )-pteronyssinus, and another house dust mite (floor mite), D -farinae, followed by Blomia, another floor mite. Out of the 32 SPT positive cases 10 (31.3%) patients opted for SLIT, after knowing the pros and cons. It can be concluded from this preliminary study that there is no doubt that SPT is a very informative confirmatory test for diagnosing allergens causing allergic rhinitis. The commonest allergen involved in causing allergic rhinitis in and around Tripura are the dust mites, commonest being D -pteronyssinus and D -farinae. SLIT has a good acceptance in the allergic rhinitis patients and out of ten all of the patients reported significant symptomatic improvement. This allergen mapping in this area is probably the first of its kind, which will help in deciding future strategies in management of AR, by immunotherapy or avoidance measures. In future many more patients may get benefit of long term cure from it.