A clinical study of inhalant allergens in patients with allergic rhinitis

Abstract

INTRODUCTIONImmunoglobulin E (IgE) predominantly mediates immunity and immune responses against parasitic infections, but it is also an essential component of type I hypersensitivity reaction, which can cause anaphylaxis, asthma, atopic dermatitis, and allergic rhinitis.1 Allergic rhinitis was defined in 1929, it is a symptomatic disorder of the nose induced after allergen exposure by an immunoglobulin E (IgE)-mediated inflammation of the membranes lining the nose. It is a global health problem that causes major illness and disability worldwide. The three cardinal symptoms in nasal reactions occurring in allergy are sneezing, nasal obstruction and mucous discharge.2 It is the cause, coexisting disorder or predisposing factor in many cases of chronic sinusitis, serous otitis, increased susceptibility to upper and lower respiratory infections and orthodontic disorders such as overbite and maldeveloped dental archs. 3The basis of any diagnosis of allergy requires a good history and examination, which should then provide a certain degree of confidence as to whether or not allergy is present. However, the diagnosis cannot be confirmed on the basis of symptoms alone, because both allergic and non-allergic conditions can present with similar symptoms. Hence, allergy testing in the form of specific IgE (sIgE) measurement is an important aid in demonstrating both the presence and severity of such an allergy. 4 ABSTRACT Background:The basis of diagnosis of allergy requires a good history and examination, however, the diagnosis cannot be confirmed on the basis of symptoms alone, because both allergic and non-allergic conditions can present with similar symptoms. Hence, allergy testing in the form of specific IgE (sIgE) measurement is an important aid in demonstrating both the presence and severity of such an allergy. The present study was undertaken to find out the common environmental allergens prevailing in Raichur causing allergic rhinitis, using carbohydrate cross reactive determinants (CCD), an in vitro test with high degree of sensitivity.Methods: The present prospective study was conducted among 30 patients with allergic rhinitis. A detailed general and ENT examination were done, X-ray of PNS, CT scan of PNS, diagnostic nasal endoscopy and nasal smear examination for eosinophils, absolute eosinophil count and serum IgE levels using Euroimmun system of in vitro assay of specific IgE antibodies. Results: Allergy to dust mite, D. faranie, corn, carnation flower, sunflower, sheep wool and straw dust were the most frequent allergens causing allergic symptoms among patients in Raichur area. Total serum IgE was elevated in all the patients, 60% were allergic to dust mite as found by anti CCD specific IgE. Conclusions: Antibodies to dust mite D. faranie, rye, T. mothy grass was the commonest finding. Identification of inhalant allergens is an important factor in prevention and treatment of allergic rhinitis.