Local allergic rhinitis in elderly patients

Bożek, Andrzej; Ignasiak, Beata; Kasperska−Zając, Alicja; Ścierski, Wojciech; Grzanka, Alicja; Jarząb, Jerzy

doi:10.1016/j.anai.2014.12.013

Cited by 56 publications

(61 citation statements)

References 10 publications

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“…The course of nasal symptoms, regardless of severity, in this type of allergy can mimic chronic non-AR; therefore, in a significant group of patients, the true diagnosis of LAR was significantly delayed. This problem has also been reported by other authors [13,14]. In accord with other studies, NPT with a suspected allergen helped resolve the proper mechanism of chronic rhinitis in some study patients [15,16].…”

Section: Discussionsupporting

confidence: 74%

Local Allergic Rhinitis in Adult Patients with Chronic Nasal Symptoms

Krajewska-Wojtys¹,

Jarząb²,

Zawadzińska³

et al. 2017

Int Arch Allergy Immunol

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Background: Local allergic rhinitis (LAR) remains an underdiagnosed condition characterized by the local production of IgE antibodies during the natural exposure to aeroallergens. The prevalence of LAR in adult patients with a previous diagnosis of non-AR was assessed. Material and Methods: Eighty-four patients with perennial nasal allergy symptoms but a negative skin prick test and specific IgE antibodies against common inhalant allergens were included in the study. Nasal provocation tests were performed with the inhalant allergens Dermatophagoides pteronyssinus, Alternaria, and cat allergen, followed by the detection of nasal-specific IgE antibodies in the lavage during the challenge. Results: LAR was confirmed in 21 (25%) study patients. In the remaining 63 (75%) patients, non-AR was diagnosed. In addition, LAR was found following exposure to D. pteronyssinus in 19 (22.6%) patients, Alternaria in 3 (3.6%) patients, and the cat allergen in 1 (1.2%) patient. In 2 patients, concomitant allergies to D. pteronyssinus and Alternaria were observed. Conclusion: LAR can be a form of chronic perennial rhinitis that has previously been considered to be non-AR.

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Section: Discussionsupporting

confidence: 74%

Local Allergic Rhinitis in Adult Patients with Chronic Nasal Symptoms

Krajewska-Wojtys¹,

Jarząb²,

Zawadzińska³

et al. 2017

Int Arch Allergy Immunol

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“…A recent study reported that the prevalence of LAR in children was 3.7% [19] . Previous studies reported a prevalence of 25.7% in adults [20] , 21.0% in elderly patients [12] , and 54-62% [8,21,22] in nonsensitized adult rhinitis patients. The lower prevalence of LAR in children might be related to the high agreement of SPT and NPT results in children.…”

Section: Discussionmentioning

confidence: 99%

“…The lower prevalence of LAR in children might be related to the high agreement of SPT and NPT results in children. Moreover, the lower prevalence in children might result from the use of different diagnostic criteria [23] , small samples sizes [5,8,21] , the lack of controls [12,20,21] , the exclusion of incidentally sensitized controls [22] , or innate differences between children and adults.…”

Section: Discussionmentioning

confidence: 99%

“…Previous researchers have defined a positive NPT result as an increase of at least 30% in the total visual analog scale plus a decrease of at least 30% in the nasal volume in acoustic rhinometry (measured at 2-6 cm from the tip of the probe) [8,12,20,21] , or as an increase in unilateral nasal resistance of >50% above the baseline value [22] . These definitions are limited, in that they are not based on established criteria but on the degree of change without considering the controls.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies of LAR have investigated the local production of allergic mediators, and, along with positive nasal provocation tests (NPTs), have demonstrated an increase of IgE in nasal secretions [8][9][10][11] . The prevalence of LAR may vary from 47 to 62.5% [8,12] in nonsensitized patients [9] . However, previous studies are limited in that they included only adults, did not have controls, or else used different diagnostic criteria for LAR.…”

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confidence: 99%

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Prevalence and Clinical Characteristics of Local Allergic Rhinitis in Children Sensitized to House Dust Mites

Lee

et al. 2017

Int Arch Allergy Immunol

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Objective: The prevalence of local allergic rhinitis (LAR) in nonatopic children remains unknown. This study aimed to determine the prevalence, clinical characteristics, and severity of LAR in children in comparison to classical allergic rhinitis (AR) and nonallergic rhinitis (NAR). Study Design: A total of 145 children (aged 1-18 years) were enrolled and classified into 3 groups (AR, NAR, and LAR) based on a skin prick test (SPT) and a nasal provocation test (NPT) with house dust mite, i.e., Dermatophagoides pteronyssinus. NPT positivity was defined as a symptom score ≥2 standard deviations (SDs) above the healthy control score. Results: Eighty-one children had AR (55.9%), and 64 (44.1%) had symptoms of rhinitis with negative SPT; 59 NAR (40.7%) and 5 LAR (3.4%) children were identified. The κ score for agreement between the SPT and the NPT results was 0.778 (95% CI 0.726-0.830, p < 0.001). A significant correlation was observed between wheal diameter and maximum nasal symptom score provoked by D.pteronyssinus (rho = 0.589, p < 0.001). Nasal severity according to the ARIA guideline did not show any differences in the 3 groups (p = 0.693). The AR group was older than the LAR and NAR groups (AR > LAR > NAR, p = 0.003). Conclusions: Despite the evidence to support the existence of LAR in pediatric populations, we found that its prevalence was relatively low, possibly due to the high rate of agreement between SPT and NPT. Further investigations are needed to identify immunological as well as clinical implications of LAR.

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