Clinical Manifestations Of Allergic Rhinitis Research Articles

Allergic rhinitis behavioral changes after Indonesian house dust mites allergenic extract administration as immunotherapy.

Allergy is a hypersensitivity reaction that is generally mediated by Immunoglobulin E (IgE). More than 25% of the world's population is suspected of having these various diseases, and the prevalence and progression of these diseases have continued to increase significantly in recent years. Among these allergyrelated diseases, allergic rhinitis and food allergy are the types of allergies with the highest prevalence. Clinical manifestations of allergic rhinitis include sneezing, rhinorrhea, nasal itching, and nasal congestion. This study aimed to determine the behavioral changes of allergic rhinitis after Indonesian House Dust Mites (IHDM) allergenic extract administration as an immunotherapy. Eight male BALB/c mice aged 6-8 weeks in each group were treated for seven groups. The sensitization phase is given intraperitoneal, the desensitization phase is given by subcutaneous, and the challenge phase is given intranasal. The allergic parameters were observed, such as nose rubbing and sneezing. The parameters were observed for 15 minutes after the challenge administration. The results showed that the administration of Indonesian House Dust Mites as immunotherapy decreased the frequency of nose rubbing and sneezing after the administration of immunotherapy compared to the allergic rhinitis model. The administration of the Indonesian House Dust Mites as immunotherapy decreased the allergic rhinitis immune response by altering the behavioral parameter.

Prevalence, Diagnosis and Management of Allergic Rhinitis in Asthmatic Children

Allergic rhinitis is a prevalent upper airway inflammatory disease that is especially widespread in the paediatric population. In the medium- to long-term, allergic rhinitis can have a significant impact on quality of life, sleep, and everyday functioning. Watery rhinorrhea, nasal congestion and obstruction, sneezing, and nasal itch are the hallmark clinical manifestations of allergic rhinitis. The diagnosis is based on a thorough history, a chest and nasal examination, and tests for certain immunoglobulin E. Usually, allergic rhinitis coexists with other allergic diseases, including asthma and allergic conjunctivitis. Asthma and allergic rhinitis are prevalent conditions that often coexist. In the literature, this idea has been referred to as a unified airway disease. According to epidemiological research, rhinitis is a common co-occurring condition in most asthma patients, and having rhinitis increases the chance of developing asthma. Patients with rhinitis and asthma have similar physiologies. Avoiding allergens that trigger allergic rhinitis and using pharmacological therapies in accordance with guidelines are essential for its proper management. A tripartite treatment plan incorporating pharmacological treatment, immunotherapy, and environmental control is recommended for the optimal management of allergic rhinitis. However, the sole treatment for the cause is still allergen-specific immunotherapy and various nutraceuticals have been employed for symptomatic relief.

The effectiveness of anti-IgE therapy for allergic rhinitis in patients with severe atopic bronchial asthma and concomitant allergic rhinitis in real clinical practice

BACKGROUND: Omalizumab, by binding IgE in atopic patients, can improve clinical and functional parameters and patients' quality of life.
 AIMS: to evaluate efficacy of anti-IgE-therapy in patients with allergic rhinitis treated with omalizumab for concomitant severe atopic asthma in real clinical practice.
 MATERIALS AND METHODS: An open, non-interventional, prospective and non-randomized study in a real clinical practice.
 The study was conducted in the Sverdlovsk region in October 2021 based on a regional registry of adult patients with severe asthma with chronic nasal inflammatory diseases and receiving targeted therapy. Dynamics of nasal symptoms was assessed using SNOT-22 questionnaire and visual analogue scale initially, after 4 and 12 months of omalizumab therapy. Peripheral blood eosinophils level was also assessed before and after 4 months of omalizumab therapy.
 RESULTS: The study included 26 patients. Assessment of nasal symptoms dynamics using the SNOT22 questionnaire at baseline and after 4 months on omalizumab therapy revealed decrease in the severity of symptoms (p 0.001): baseline - 46.8522.04 points (95% CI 37.94-55.75), after 4 months - 30.6514.81 points (95% CI 24.67-36.64). Also improvement in SNOT22 questionnaire score was revealed in 18 patients treated with omalizumab during 12 month: before therapy - 47.5 points (Q₁ -Q₃: 35.7-59.3), after 4 months - 30.4 points (Q₁- Q₃: 22.1-38.1), after 12 months - 24.9 points (Q₁ -Q₃: 16.9-32.9) (p = 0.001). Improvement in rhinitis symptoms control was observed according to the VAS scale: VAS before therapy - 8.0 points (Q₁-Q₃: 6.2-9.0), after 4 months - 5.0 points (Q₁- Q₃: 3.2-5, 8), after 12 months of treatment - 5.0 points (Q₁-Q₃: 4.0-6.8). The level of eosinophils (n=16) decreased from 510.9317.9 (95% CI 341.5680.3) cells /l to 327.4217.7 (95% CI 211.4443.5) cells /l after 4 months of anti-IgE-therapy (p0.041).
 CONCLUSIONS: Omalizumab in real clinical practice has demonstrated improvement of rhinitis symptoms control and quality of life in patients with allergic rhinitis with concomitant severe atopic asthma. It was accompanied by a statistically significant decrease in peripheral blood eosinophils level, that largely determines airway inflammation severity and clinical manifestations of allergic rhinitis and bronchial asthma.

Real possibilities of treatment of patients with allergic rhinitis

Allergic rhinitis occupies a special place among diseases of the upper respiratory tract. Every year the urgency of the problem increases due to the annual increase in the incidence among all age groups of the population. Allergic diseases are often associated with other respiratory diseases or cause them, which requires early diagnosis and selection of competent therapy. Allergic reactions can range from seasonal allergens, such as tree or weed pollen, to year-round irritants, such as dust and pet dander. Currently, the pathogenesis of allergic rhinitis is being actively studied. There is still debate about the most accurate classification of allergic rhinitis, reflecting all its aspects, such as the time of onset and duration of symptoms, their impact on patients’ lives. This is necessary to find the best methods of treatment with maximum efficiency. The main clinical manifestations of allergic rhinitis are nasal itching, sneezing, swelling of the nasal mucosa and rhinorrhea. Often, to relieve symptoms, patients are forced to take many drugs for a long time, which has a significant impact on their quality of life. All over the world, new ways are being developed to optimize the treatment of this group of patients, among which combinations of several drugs used to treat allergic rhinitis, which meet all safety and efficacy requirements. The most commonly used and most effective combinations of drugs are combinations of intranasal glucocorticosteroids with topical histamine H1 receptor antagonists, as well as leukotriene receptor blockers with oral antihistamines.

Determination of co-sensitization is an important step in improving the effectiveness of allergen-specific immunotherapy in patients with pollen disease

In order to increase the effectiveness of allergen-specific immunotherapy in patients with pollen disease, the profile of allergen sensitization was determined at the molecular level, performed in 47 patients with clinical manifestations of seasonal rhinoconjunctivitis and perennial allergic rhinitis during a long time period. Allergic examination of patients included history taking, molecular blood tests using ALEX technology to determine the level of specific antibodies class lgE of major and minor components of pollen and household allergens and diagnostic skin tests (pre-test). Assessment of the main clinical manifestations of allergic rhinitis was performed according to the recommendations of the European Association of Allergists and Immunologists. The severity of nasal symptoms was determined by the TNSS scale, and ocular symptoms - by the TOSS scale. Integral assessment of the intensity of clinical symptoms of allergic rhinitis was calculated as the sum of scores by the main symptoms. According to the results of molecular allergy diagnostics, the profile of allergic sensitization in patients with pollen disease was determined, which established the presence of specific lgE - antibodies to major allergy components of ragweed pollen (nAmb a1) – in 91.5±4.1% of patients, wormwood (nArt v3, nArt v1) – in 40.4±7.2%, meadow thyme (rPh1 p1, rPh1 p5b) – in 17.0±5.5%, house dust mites (Der p1, Der p2) – in 29.8±6,7%. Developed on the basis of molecular allergy diagnostics, the profile of allergological sensitization to allergocomponents allows to obtain complete and detailed information on patient sensitization (diagnose a real allergy), cross-reactivity to other allergens, justify the feasibility and predict the effectiveness of allergen-specific immunotherapy.

Role of sugarcane pollen in allergic rhinitis: a case-control study

L´identification des allergènes est essentielle dans la prise en charge de la rhinite allergique. La canne à sucre produit un pollen anémophile. L´objectif de notre étude était de déterminer la place du pollen de canne à sucre dans la survenue de la rhinite allergique. Il s´agit d´une étude analytique type cas-témoins, menée de juillet 2017 à juin 2018, chez des patients habitants une commune rurale malgache dans laquelle la culture et le traitement de la canne à sucre constituent les principales occupations. Elle incluait 182 patients (91 cas et 91 témoins). Les facteurs associés à la survenue des signes de rhinite allergique étaient la distance de moins de 500 mètres entre les domiciles et les champs de canne à sucre (OR = 1,50), la profession exercée en contact direct avec la canne à sucre (OR=116) et la présence d´antécédent familial de rhinite allergique (OR=13,67). Par ailleurs, l´exposition aux rafales (OR=0,84) et la profession exercée en plein air (OR=0,92) étaient des facteurs protecteurs. L´exposition des patients au pollen de canne à sucre est associée aux manifestations cliniques de la rhinite allergique et confirme la place que tient cet allergène dans la survenue de ladite pathologie. Des mesures d´éviction et d´hygiènes constituent par conséquents la base du traitement.

Антигістамінні препарати для лікування алергічного риніту в дітей

В огляді літератури подані сучасні відомості щодо клінічної ефективності, безпеки та переносимості класичного представника другого покоління H1-антигістамінних препаратів дезлоратадину при лікуванні алергічного риніту в дітей. Для написання статті здійснювався пошук інформації з використанням баз даних Scopus, Web of Science, MedLine, PubMed, Google Scholar. Надана коротка характеристика фармакокінетики та фармакодинаміки дезлоратадину, що є потужним і селективним щодо H1-рецепторів зворотним агоністом із найтривалішим періодом напіврозпаду, який не проникає через гематоенцефалічний бар’єр і не має седативної дії. Акцентовано увагу на здатності дезлоратадину не тільки ефективно пригнічувати гістамінасоційовані клінічні прояви алергічного риніту, але й пригнічувати активність запального процесу за рахунок зниження активності фактора транскрипції NF-kB. У наукових дослідженнях показана висока ефективність дезлоратадину в купіруванні клінічних проявів алергічного риніту в дітей та вказано на хороший профіль безпеки під час його використання.

Mometasone furoate in the treatment of allergic rhinitis: a complex therapeutic effect

The review examines the role of mometasone furoate (NSMF) intranasal spray (Nasonex) in the treatment of allergic rhinitis (AR). There is a wide prevalence of AR both among children and adults, its adverse effect on the quality of life of patients. It is emphasized that the main means of therapy for moderate and severe course in accordance with international and Russian recommendations for the diagnosis and treatment of AR are intranasal glucocorticosteroids (INGKS). The pharmacological features of the MF molecule that underlie its efficacy and safety, including the affinity, lipophilicity and viscosity of the drug, as well as low systemic bioavailability, are discussed in detail. The therapeutic effects of NSMF in the treatment of seasonal and perennial AR, its effect on nasal symptoms are discussed in detail. The beneficial effect of NSMF therapy on nasal congestion is emphasized separately. The beneficial effect of NSMF treatment on other clinical manifestations of AR, including ocular symptoms, effects on sleep, and olfactory function, has been noted. The safety issues of NSMF use are discussed in detail, including systemic effects, such as effects on adrenal function, eye, and growth retardation in children, and local adverse effects on the nasal mucosa; there is a high profile of local and systemic safety of long-term use of NSMF in the treatment of AR in both adults and children.

Study of vitamin C therapy in allergic rhinitis

<p><strong>Background:</strong> Vitamin C has a therapeutic role in allergic rhinitis by reduction of oxidative stress and inflammation. The present study has been undertaken to evaluate the improvement or otherwise in the clinical manifestations of allergic rhinitis, following supplementation of this vitamin.</p><p><strong>Methods: </strong>40 subjects of allergic rhinitis were selected from the allergy clinics of Dayanand medical college and hospital. The study period was one and a half year. Vitamin C in the dose of 1 gm per day was administered in the case group and in the placebo group a sugar tablet was administered by the oral route. Plasma levels of ascorbic acid and its effect on the symptoms and signs of rhinitis were recorded.</p><p><strong>Results:</strong> The mean duration of illness in the patients with allergic rhinitis was 10.15±3.4 years, with 25 patients having duration of less than 10 years, 10 patients were with of illness between 10 to 20 years and 5 having duration more than 20 years. The most common complaint in patients with allergic rhinitis was of nasal obstruction (57.5%).</p><p>All the patients who showed improvement had increase in plasma ascorbic after the respective treatment but not all the patients showing increase in plasma ascorbic acid post-treatment showed improvement.</p><p><strong>Conclusions: </strong>Vitamin C ameliorates the signs and symptoms of allergic rhinitis by raising the plasma ascorbic acid levels.</p>

Comparison of allergens and symptoms in patients with allergic rhinitis between 1990s and 2010s

BackgroundThe prevalence of allergic rhinitis (AR), an environment- and lifestyle-dependent condition, has been constantly increasing in Korea. Although the environment and lifestyle of the Korean people have recently undergone rapid changes, corresponding changes in the characteristics of AR patients have not been well documented. Therefore, we aimed to outline the changes in allergens and clinical manifestations of AR in Korean patients from the 1990s and 2010s.MethodsWe reviewed 1447 and 3388 AR patients who visited the same tertiary hospital in the 1990s and 2010s, respectively. All patients were diagnosed with AR based on the presence of characteristic symptoms, positive skin prick test results, and answered a symptom questionnaire at the time of visit. We compared differences in the allergens and results of the symptom questionnaire between the two sets of patients.ResultsWhen compared with the 1990s, the rate of sensitization to house dust mites, cockroaches, Aspergillus, Alternaria, and tree pollen significantly increased and that to cat fur significantly decreased in patients from the 2010s (all P < 0.05). Male predominance was observed with two peaks in the age distribution of patients from the 2010s. The proportion of patients with moderate-to-severe nasal obstruction and itching of the nose/eye increased (each P < 0.05) and that of patients with minor symptoms such as olfactory disturbances, cough, sore throat, and fatigue also increased (all P < 0.01) in the 2010s.ConclusionsAllergen reactivity and type and symptom severity in Korean AR patients significantly varied between the 1990s and 2010s. Our results may therefore be helpful for patient counseling and management.

Modern possibilities of pathogenetic therapy of patients with allergic rhinitis

The incidence of allergic rhinitis has been increasing rapidly worldwide in recent years. About 40% of the world’s population suffer from allergic inflammation of the nasal mucous membrane. Clinical manifestations of allergic rhinitis are absence or difficulty of nasal breathing, itching, sneezing, nasal congestion and rhinorrhoea, as well as swelling of the face, the presence of dermatitis in the region of the nasal wings, general malaise, smell disturbance. Manifestations of allergies by ENT organs in most cases do not pose a threat to life, but they can cause the development of other pathological processes, bad sleep, irritability, decreased efficiency, mood swings, which, in turn, adversely affects human health and reduces the quality of life. The pathogenesis of allergic rhinitis is based on an immediate hypersensitivity. According to the modern classification, depending on the nature of the course of the disease it is common to identify intermittent and persistent forms.At present, the drugs of choice in the treatment of patients with allergic rhinitis are intranasal glucocorticosteroids. However, the presence of a concomitant pathology of the nasal cavity in the patient, such as deviated septum, not only significantly impairs the course of nasal inflammatory process, but also creates obstacles to adequate delivery of topical drugs to all parts of the nasal cavity, which, in turn, reduces their effectiveness.For patients suffering from allergic rhinitis in combination with other pathology of the nasal cavity, combined oral medications may be a good alternative to intranasal sprays. Certain interest for doctors is caused by the appearance of a combined antihistamine drug on the Russian market, which includes a blocker of leukotrienes and H1-histamine receptors of the second generation – montelukast and levocetirizine. The drug can be used both in adults and children from 15 years old for treatment of intermittent and persistent forms of allergic rhinitis.Timely and properly performed therapy of allergic rhinitis allows to eliminate symptoms of the disease and prevent the development of complications.

Possibilities of sublingual allergen-specific immunotherapy in preschool children with sensitization to mold fungus allergens

Purpose. Determination of the efficacy of sublingual allergen-specific immunotherapy (SLIT) in preschool children with sensitization to allergens of mold Alternaria alternata.Materials and methods. The study involved 447 children aged 4.1 ± 0.9 years (from 3 to 7 years old), with verified diagnoses of allergic bronchial asthma and/or allergic rhinitis. In 58 patients with proven sensitization to Alternaria alternata major allergens, the efficacy of sublingual allergen-specific immunotherapy (SLIT) was assessed, which was carried out for 3 years and evaluated using a visual analogue scale (VAS) and the sIgE level to the major component of Alternaria Alt a1. 27 children (group II) who received exclusively basic therapy were included in the comparison group.Results. During three years, SLIT in patients of the first group showed a significant decrease in the frequency of nasal symptoms: sneezing from 29 (26; 31) mm to 8 (6; 11) mm (P = 0.008), rhinorrhea from 29 (26; 34 ) mm to 5 (4; 6) mm (P = 0.012) mm, itching from 20 (17; 23) mm to 5 (4; 6) (P = 0.002) mm and nasal congestion from 29 (25; 35) mm to 7 (5; 9) mm (P = 0.016) compared with the initial level. Similar dynamics were observed with the nasal symptoms itching of the eyes, redness of the eyes and discharge from the eyes, which significantly decreased from 26 (23; 31) mm to 5 (3; 7) mm (P = 0.007), from 29 (26; 36) mm to 4 (3; 6) mm (P = 0.014) and from 29.5 mm to 5.0 (4; 7) mm (P = 0.003) in comparison with the initial values. Dynamics were also observed in relation to asthma symptoms, namely, the cough and shortness of breath indices reliably decreased from 54 (46; 61) mm to 7 (6; 9) mm (P = 0.013) and from 50 (39; 57) mm to 7 (5; 9) mm (P = 0.011) compared to baseline values. It should be noted that the indicators of VAS in children after the end of the SLIT course were significantly lower than those in children who received basic therapy.Conclusions. The study showed that the use of sublingual immunotherapy in children with sensitization to mold Alternaria alternata and the presence of clinical manifestations of allergic rhinitis and / or allergic bronchial asthma, is an effective and safe treatment method and allows to gain control over symptoms of the disease quickly (within the first 6 months).

Clinical Manifestations of Allergic Rhinitis by Age and Gender: A 12-Year Single-Center Study.

Currently, epidemiological data on allergic rhinitis collected through the skin prick test are scarce. Moreover, the relationship of age and sex to allergic rhinitis is not comprehensively understood. This study aimed to characterize allergic rhinitis and the associated clinical manifestations by age and sex. We retrospectively investigated data from 2883 patients who visited a single university hospital for rhinitis symptoms between January 2003 and December 2014. Of these 2883 patients, 1964 who underwent a skin prick test with 11 standardized allergen extracts and completed a nasal symptom questionnaire were enrolled. The clinical characteristics of allergen sensitization and nasal symptoms were analyzed by sex and age distribution. The prevalence of allergen sensitization progressively decreased with age after peaking at between 20 and 29 years. The sensitization rate was higher in males than in females (P = .046). The sensitization rate to house dust mites decreased with age, while sensitization to mugwort and ragweed increased. Six allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, mugwort, trees, ragweed, and cats) were sufficient to identify >96% of patients with allergen sensitization. Nasal obstruction tended to decrease with age and was more prevalent in males (P = .002) than in females, while rhinorrhea (P = .007) and itching (P = .013) were more prevalent in females. Total nasal symptom scores did not differ by sex. The clinical characteristics of allergic rhinitis, including allergen-sensitization patterns and related symptoms, varied by age and sex. Six common allergens could be sufficient to generate a cost-effective tool to identify allergic rhinitis.

GENETIC AND ENVIRONMENTAL FACTORS AS STRONG DETERMINANTS OF ATOPIC ALLERGIC DISEASE CLINICAL MANIFESTATIONS IN SURABAYA'S SCHOOL CHILDREN

This case-control study was conducted to assess the relative role of genetic and environmental factors in determining the clinical manifestations of atopy allergy disease in school children, which is part of a large study of the prevalence of allergic diseases in school children in Surabaya. Using a simple multi-stage random sampling, 348 children from 5 elementary schools, 4 junior high schools, and 4 senior high schools in Surabaya were involved in the study. The subjects of the study along with her parents were guided to fill out the modified ISAAC questionnaire and underwent physical examination and skin prick test using 27 common allergen types found in the environment. For the analysis, 110 school children were randomly selected from the parent sample and included in the case group of 55 people (positive skin prick test against &gt; 1 type of allergen), and the control group of 55 people (negative skin prick test). All genetic and environmental factors data were collected and analyzed. Most of the subjects had clinical manifestations of allergic rhinitis (66.36%), asthma (21.82%), food allergies (10.9%), and atopic dermatitis (6.36%). Complete models for multiple logistic regression analysis can only be performed for overall atopic disease and allergic rhinitis disease. The first birth order and exposure to home dust mites were the most significant clinical manifestations of atopy disease (OR 4.548, 95% CI: 1.813-11.410, p=0.01). Atopy status of the father was the only significant determinant factor for the manifestation of allergic rhinitis in the study subjects (OR 3.929; 95% CI: 1.143-13.052, p=0.03). Both genetic and environmental factors interacted and determined clinical manifestations of atopy allergy disease in school pupils. The father's genetic factors were more dominant than maternal genetic factors in determining the clinical manifestations of allergic rhinitis in offspring.

BASIC PRINCIPLES OF ALLERGIC RHINITIS THERAPY IN PAEDIATRIC PRACTICE

The article introduces the main mechanisms for developing an allergic reaction, and describes the main clinical manifestations of allergic rhinitis. The basic principles of therapy are covered. Special attention is paid to the use of the Vibrocil combination drug, which contains dimethindene blocking H1-histamine receptors and phenylephrine

Study for Assessing Prevalence and Phenotypes of Local Allergic Rhinitis

Background: Rhinitis is a global health problem that affects 20-40% of the population in developed countries and whose incidence is rising. Rising is characterized by one or more of the following symptoms: nasal congestion, rhinorrhea, sneezing and itching. It can be induced by different mechanisms and involves several etiological agents. Noninfectious rhinitis has traditionally been classified as allergic rhinitis (AR) and nonallergic rhinitis (NAR). Objective: To evaluate the prevalence and phenotypes of local allergic rhinitis in patients with clinical manifestations of AR without evidence of systemic IgE sensitization. Methods: This cross sectional, case-control, and nonrandomized study was conducted on 120 patients with clinical manifestations suggestive of allergic rhinitis (selected from the allergy outpatient clinic at Ain Shams university hospitals and 20 healthy controls. Results: Local allergic rhinitis was diagnosed in 80% of females and 20% of males. While the patients with systemic allergic rhinitis reached 37.5% for males, and 62.5% were females. Regarding the persistence of symptoms in local allergic rhinitis it reached 88% in comparison to 67.5% in systemic allergic rhinitis. The symptoms were intermittent in 12 % of cases with local allergic rhinitis in comparison to 32.5% in systemic allergic rhinitis. The severe symptoms outweighed the mild symptoms by nearly 50%. The skin prick test reached 80% positive in cases of LAR. Those with normal levels of total IgE level, the nasal provocation test was positive in 12.5% of cases and 7.5% negative.

The impact of environmental factors on quality of life and symptoms of children with allergic rhinitis

Allergic rhinitis is an inflammation of the nasal mucosa caused by exposure to allergens, which impairs the cognitive capabilities of the affected. ObjectiveTo correlate the mean scores of quality of life of children and adolescents with symptoms of allergic rhinitis and the presence of household environmental factors described in the literature as allergy triggers. MethodThis cross-sectional retrospective cohort study included 120 children and adolescents presenting clinical manifestations of allergic rhinitis. The subjects were divided into two groups based on the number of allergy-triggering environmental factors seen in their households. Scale PedsQL 4.0 was used to quantify quality of life and allow further comparisons between groups. ResultsNo statistically significant differences (p > 0.05) were seen in the PedsQL mean scores when participant quality of life was analyzed vis-a-vis triggering environmental factors. However, the incidence of allergy manifestations was higher in children exposed to more environmental factors. ConclusionThe studied environmental factors were not correlated with patient quality of life. However, the analysis of patient households and symptoms indicates the environment played a role in the onset of allergy events.

APPLICATION OF DECONGESTANTS IN THE TREATMENT OF ALLERGIC RHINITIS

Efficiency of application of a preparation xylometazoline is shown in the treatment of allergic rhinitis (AR). Expediency of xylometazoline inclusion in symptomatic therapy of patients having clinical manifestations of AR is noted.

235 Frequency of Patients With Clinical Manifestations of Allergic Rhinitis without Evidence of Systemic Atopy and Specific ige Sensitization

BackgroundThe diagnosis of allergic rhinitis (AR) is based on clinical manifestations and supported by a positive result for skin prick test (SPT) or serum specific immunoglobulin E (sIgE) antibodies to aeroallergens. Our objective was to investigate the frequency of patients with clinical manifestations of AR without evidence of specific IgE sensitization.MethodsWe evaluated patients with clinical manifestations suggestive of AR, other causes of rhinitis excluded, aged >5 years and who had total serum IgE and SPT or sIgE to aeroallergens measured. Skin tests were performed with extracts of Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis and Aspergillus fumigatus (FDA Allergenic) and total serum IgE and sIgE, for the same allergens, by ImmunoCAP (Phadia). Patients were subdivided into groups according to the results profile, and comparatively analyzed for association with asthma, severity of rhinitis and age.ResultsWe evaluated 116 patients (64% female) aged between 5 and 79 years, including 34 children (29%) and 63 (54%) with bronchial asthma. The observed profiles and frequencies were: high IgE levels and positivity in the SPT or sIgE –55%; normal IgE levels and SPT or sIgE positivity –9%; high IgE levels and SPT and sIgE negativity –3 %; normal IgE levels and negativity in the SPT and sIgE –23%. Among patients with normal levels of total serum IgE and no evidence of specific IgE sensitization, 14% had asthma, while in the remainder the prevalence of asthma was 34% (P = 0.0009). There was no statistical significance in the influence of the rhinitis severity and age in the absence of markers of atopy and allergen sensitization.ConclusionsWe observed a significant number of patients with clinical manifestations of AR, without evidence of systemic atopy and specific IgE sensitization, indicating the importance of careful research of local allergic rhinitis, as well as other causes of chronic rhinitis. Local allergic rhinitis appears to be less frequent in patients with rhinitis and asthma. The observation of 13% of patients with elevated levels of total IgE without specific sensitization implies the possibility of sensitization to aeroallergens which were not investigated, such as occupational allergens.

Clinical Manifestations of Allergic Rhinitis

Objective: To provide a concise review of the classification, nasal manifestations, non-nasal manifestations, and quality of life impact of allergic rhinitis. Data sources: MEDLINE (PubMed) search using the terms allergic rhinitis, combined with the terms perennial, seasonal, non-nasal, symptoms and quality of life. Study selection: Human studies and reviews published in the English language. Results: The prevalence of allergic rhinitis is increasing worldwide. Symptoms include rhinorrhea, sneezing, obstruction of the nasal passages, and may be underestimated by patients. Traditionally, allergic rhinitis has been classified as perennial or seasonal; however, the Allergic Rhinitis and its Impact on Asthma (ARIA) classification may provide a better description of individual symptoms. Complications of allergic rhinitis include nasal polyps and bacterial sinusitis and comorbid conditions include asthma, allergic conjunctivitis and atopic dermatitis. The list of potential differential diagnoses is extensive, but important not to miss are the rare presentations of nasopharyngeal tumors, Wegener’s Granulomatosis and sarcoidosis. Epidemiological studies have shown a reduction in quality of life in patients suffering from allergic rhinitis and new tools have allowed for better assessments of the impact of illness on patient’s lives. Conclusion: Patients with allergic rhinitis can experience a wide range of troublesome clinical symptoms, which are often under recognized and underreported causing a delay in seeking medical attention and subsequent reduction in health related quality of life.