The results of nasal provocation test do not correlate with the sIgE level, skin prick tests, and seasonal symptoms in children suffering from allergic rhinitis and/or asthma hypersensitive to alternaria tenuis

Abstract

Rationale Nasal provocation test is a valuable diagnostic tool for determination of allergen responsible for symptoms in subjects allergic to multiple allergens. The aim of this study was to determine the correlation between the results of nasal provocation tests with Alt a I and the sIgE level, skin prick tests and seasonal symptoms in patients hypersensitive to Alternaria tenuis. Method 35 children and adolescents (mean age 10,8 years ± 3,68) suffering from allergic rhinitis and/or asthma, with mean level of sIgE for Alt a I 1,22 ± 0,88 IU/ml were included into the study. Skin prick tests (SPT) (10 000 SBE/ml) and nasal challenge (250 SBE per dosis) with Alt a I solution were performed. The symptoms (including but not restricted to dyspnea, sneezing, rhinorrhea, obstruction, itchy nose and eyes) during the season (July, August and September in our region) and after nasal provocation were gathered using an analogue scale questionnaire. Results The mean symptoms after nasal provocation with Alt a I (223,54 ± 89,0) were significantly higher as compared to diluent (31,17 ± 31,56)(p<0,0001). We did not find correlation between the symptoms after nasal provocation and sIgE level (Rs=0,21, p=0,22), SPT results (Rs=0,28, p=0,105) and symptoms of rhinitis and/or asthma during the season (Rs=−0,222, p=0,199). Conclusion The results of nasal provocation test gathered using an analogue scale do not correlate with the sIgE level, SPT results and symptoms in children and adolescents allergic to Alternaria tenuis. Other methods including acoustic rhinometry should be studied in the evaluation of the nasal provocation test results.