TY - JOUR
T1 - The distinguishing clinical features of nonallergic rhinitis patients
AU - Hamizan, Aneeza W.
AU - Azer, Mark
AU - Alvarado, Raquel
AU - Earls, Peter
AU - Barham, Henry P.
AU - Tattersall, Jessica
AU - Rimmer, Janet
AU - Kalish, Larry
AU - Sewell, William A.
AU - Harvey, Richard
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Background: Not all rhinitis patients are affected by an immunoglobulin E (IgE)-mediated inflammatory process. Skin and serum allergy assessments are limited in their ability to define local allergic rhinitis (LAR). Thus, patients with negative systemic allergy assessments comprise a mix of those who truly have nonallergic rhinitis (NAR) and patients with LAR. Objective: To determine the clinical characteristics of patients with NAR. Methods: A cross-sectional study was performed on consecutive adults with rhinitis symptoms who underwent turbinate surgery. NAR patients were defined by excluding allergy using both systemic (serum-specific IgE and/or skin prick test) and local (inferior turbinate tissue-specific IgE) tests. Allergic rhinitis (AR) patients were defined by any positive systemic or local test toward aeroallergens. The clinical characteristics studied included allergic comorbidities (asthma, eczema, allergic conjunctivitis), inhalant allergen triggers (dust, pollen, animal dander), and environmental triggers (Cincinnati Irritant Index [CII]). Results: There were 154 participants (41.79 ± 14.78 years, 37.7% female). NAR patients (11.7%) were older (49.33 ± 15.99 vs 40.78 ± 14.38 years, P =.02), had less self-reported asthma (5.6% vs 36.3%, P <.01) and house dust inhalant trigger (38.9 vs 65.2%, P =.03) compared to AR patients. The CII score was similar for NAR and AR (31.06 ± 28.88 vs 35.49 ± 24.70, P =.61). Conclusion: Patients who were older, without asthma, and lacked an inhalant allergy trigger were more likely to have true NAR. Environmental triggers are not distinguishing features of NAR. This may be used as a guide to identify rhinitis patients whose symptoms are truly nonallergic etiology compared to those with falsely negative systemic allergy assessment but may still need management for LAR.
AB - Background: Not all rhinitis patients are affected by an immunoglobulin E (IgE)-mediated inflammatory process. Skin and serum allergy assessments are limited in their ability to define local allergic rhinitis (LAR). Thus, patients with negative systemic allergy assessments comprise a mix of those who truly have nonallergic rhinitis (NAR) and patients with LAR. Objective: To determine the clinical characteristics of patients with NAR. Methods: A cross-sectional study was performed on consecutive adults with rhinitis symptoms who underwent turbinate surgery. NAR patients were defined by excluding allergy using both systemic (serum-specific IgE and/or skin prick test) and local (inferior turbinate tissue-specific IgE) tests. Allergic rhinitis (AR) patients were defined by any positive systemic or local test toward aeroallergens. The clinical characteristics studied included allergic comorbidities (asthma, eczema, allergic conjunctivitis), inhalant allergen triggers (dust, pollen, animal dander), and environmental triggers (Cincinnati Irritant Index [CII]). Results: There were 154 participants (41.79 ± 14.78 years, 37.7% female). NAR patients (11.7%) were older (49.33 ± 15.99 vs 40.78 ± 14.38 years, P =.02), had less self-reported asthma (5.6% vs 36.3%, P <.01) and house dust inhalant trigger (38.9 vs 65.2%, P =.03) compared to AR patients. The CII score was similar for NAR and AR (31.06 ± 28.88 vs 35.49 ± 24.70, P =.61). Conclusion: Patients who were older, without asthma, and lacked an inhalant allergy trigger were more likely to have true NAR. Environmental triggers are not distinguishing features of NAR. This may be used as a guide to identify rhinitis patients whose symptoms are truly nonallergic etiology compared to those with falsely negative systemic allergy assessment but may still need management for LAR.
KW - Cincinatti irritant index
KW - immunoglobulin E
KW - inferior turbinate tissue
KW - local allergic rhinitis
KW - local test
KW - nonallergic rhinitis
UR - http://www.scopus.com/inward/record.url?scp=85066845185&partnerID=8YFLogxK
U2 - 10.1177/1945892419850750
DO - 10.1177/1945892419850750
M3 - Article
C2 - 31106562
AN - SCOPUS:85066845185
SN - 1945-8924
VL - 33
SP - 524
EP - 530
JO - American Journal of Rhinology and Allergy
JF - American Journal of Rhinology and Allergy
IS - 5
ER -