Nasal blown secretion evaluation in specific occupational nasal challenges

Pignatti, Patrizia; Pala, Gianni; Pisati, Marta; Perfetti, L.; Banchieri, Gabriella; Moscato, Gianna

doi:10.1007/s00420-009-0459-9

Cited by 23 publications

(31 citation statements)

References 28 publications

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“…In addition, the inflammatory process, present in allergic airway disease, was monitored with the use of the nasal lavage fluid examination. In accordance with Pignatti et al, a cut-off value of 4% and/or 1×104 eosinophils/ml for a significant postchallenge eosinophil increase has been identified [11]. In our patient, clinical symptoms appeared and the criteria concerning the eosinophils increase were fulfilled as well.…”

Section: Case Reportsupporting

confidence: 89%

Occupational allergy to Limonium sinuatum — a case report

Wiszniewska

Pałczyński

Krawczyk-Szulc

et al. 2011

International Journal of Occupational Medicine and Environmental Health

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Decorative flowers are known to be a cause of occupational allergy in the floral industry. The allergic manifestations induced by flowers include asthma, rhinoconjunctivitis and urticaria. We present a case of a 55-year-old woman, who has been working for the last 30 years as a gardener with various kinds of flowers, e.g., Limonium sinuatum (LS), chrysanthemum, sweet William (Dianthus barbatus) and Lilium. During the last 10 years she has developed nasal and eyes symptoms, dry cough, dyspnoea, chest tightness and wheezing. Clinical examination, routine laboratory testing, chest radiography, skin prick tests (SPT) involving common allergens, native plants pollens and leaves by the prick-prick technique, rest spirometry, methacholine challenge test and specific inhalation challenge test (SICT) were conducted. SPT results to common allergens were positive for grass pollens. SPT with native plants pollens and leaves showed a positive reaction only for LS. SICT induced an isolated early asthmatic reaction and significant increase in the number of eosinophils in the nasal lavage fluid. Additionally, significant increase in non-specific bronchial hyperreactivity was observed after SICT. To our knowledge, the presently described report is the first one of Limonium sinuatum induced occupational asthma and rhinitis in a Polish gardener.

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Section: Case Reportsupporting

confidence: 89%

Occupational allergy to Limonium sinuatum — a case report

Wiszniewska

Pałczyński

Krawczyk-Szulc

et al. 2011

International Journal of Occupational Medicine and Environmental Health

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“…The assessment of nasal symptoms is not always sufficient to document a nasal reaction; symptom scores should be combined with objective measurements, i.e. demonstration of a significant decrease in nasal patency and/ or evidence of nasal inflammation [100][101][102][103].…”

Section: Exhaled Nitric Oxidementioning

confidence: 99%

Specific inhalation challenge in the diagnosis of occupational asthma: consensus statement

Vandenplas

Suojalehto

Aasen

et al. 2014

European Respiratory Journal

178

144

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This consensus statement provides practical recommendations for specific inhalation challenge (SIC) in the diagnosis of occupational asthma. They are derived from a systematic literature search, a census of active European centres, a Delphi conference and expert consensus. This article details each step of a SIC, including safety requirements, techniques for delivering agents, and methods for assessing and interpreting bronchial responses. The limitations of the procedure are also discussed.Testing should only be carried out in hospitals where physicians and healthcare professionals have appropriate expertise. Tests should always include a control challenge, a gradual increase of exposure to the suspected agent, and close monitoring of the patient during the challenge and for at least 6 h afterwards. In expert centres, excessive reactions provoked by SIC are rare.A positive response is defined by a fall in forced expiratory volume in 1 s o15% from baseline. Equivocal reactions can sometimes be clarified by finding changes in nonspecific bronchial responsiveness, sputum eosinophils or exhaled nitric oxide. The sensitivity and specificity of SIC are high but not easily quantified, as the method is usually used as the reference standard for the diagnosis of occupational asthma. @ERSpublications ERS Task Force: a statement on specific inhalation challenges in the diagnosis of occupational asthma

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“…In spite of new techniques for allergic rhinitis diagnosis, still nasal smear specifically for eosinophilia has some role either in diagnosis or treatment evaluation. 17,18 The diagnosis of allergy in allergic rhinitis, is a difficult challenge and requires careful and broad analysis. This is due to both the diversity of the symptoms of the disease and absence of specific and reliable laboratory tests.…”

Section: Discussionmentioning

confidence: 99%

Assessment of cost effectiveness of antihistaminics in allergic rhinitis patients in rural region by Nasal cytology: a simple and inexpensive tool

Pentewar

Wagh

Chincholkar

2018

Int J Basic Clin Pharmacol

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Background: This study was to assess the usefulness of nasal smear as a quick, easy and inexpensive diagnostic method for allergic rhinitis and for assessment of the cost effectiveness of antihistaminics.Methods: This study was conducted in rural setting of tertiary care hospital. Nasal smears were taken from 52 patients with a clinical history of nasal allergy having nasal congestion score of at least 3 or more. Nasal smears were stained with Hematoxilin-Eosin and examined by pathologists.Results: A total of 52 patients 13 in each groups of the age group 18 to 65 years (Mean age, 33.73±10.23 years); 48.08% are Female and 51.92% are Male were randomized and received either Cetirizine, Levocetirizine, Loratadine, or Fexofenadine over a period of one week. The association of eosinophil before and after the treatment was obtained using logistic regression analysis for each treatment separately. Eosinophil is marginally associated with Cetirizine before and after treatment.Conclusions: Evaluation of eosinophils in nasal smear is an insensitive but cheaper test for the diagnosis of allergic rhinitis and use as a simple tool for comparison of cost effectiveness among commonly used oral antihistaminics. pharmacoeconomic analysis of present comparative clinical study shows that cetirizine is a better choice in comparison with levocetrizine, loratidine and fexofenadine due to its cost effectiveness.

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Nasal blown secretion evaluation in specific occupational nasal challenges

Abstract: Eosinophil evaluation in nasal blown secretions is an important tool in monitoring the response to occupational specific nasal challenges.

Cited by 23 publications

References 28 publications

Occupational allergy to Limonium sinuatum — a case report

Occupational allergy to Limonium sinuatum — a case report

Specific inhalation challenge in the diagnosis of occupational asthma: consensus statement

Assessment of cost effectiveness of antihistaminics in allergic rhinitis patients in rural region by Nasal cytology: a simple and inexpensive tool

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