Seasonal idiopathic rhinitis with local inflammatory response and specific IgE in absence of systemic response

Abstract

These results support the hypothesis that a subgroup of patients with IR have seasonal symptoms with evidence of a nasal allergic immune reaction in the absence of a positive SPT or serum specific IgE.

The Relevance of Nasal Provocation Testing in Children with Nonallergic Rhinitis

“…These patients have no serum-specific IgE, have negative skin and intradermal tests, and are categorized as LAR [2,3,6,9]. We believe that this is the first and only study of LAR in childhood as we could not find any such study in the English literature up toAugust 2013.…”

“…There were no differences in the symptoms between the positive and negative NPT groups. Rondón et al [2] reported that posterior nasal secretion was the most common symptom in patients with idiopathic rhinitis and sneezing was the most frequent among patients with allergic rhinitis.…”

“…Powe et al [6] enounced ‘entopy' by describing the activation of a Th2 immune response in the nasal mucosa of nonallergic rhinitis patients. In European studies it has been estimated that LAR may affect 47% of adult patients with perennial symptoms and 62.5% with seasonal symptoms [2,7]. There were previously no data about the prevalence of LAR in children.…”

“…In recent years, local allergic rhinitis (LAR) has been defined as a new phenotype of allergic rhinitis characterized by nasal symptoms of allergic rhinitis in the absence of sensitivity in a skin prick test (SPT) or serum-specific IgE, a positive response to a specific nasal provocation test (NPT) and the presence of a Th2 immune inflammatory response in the nasal mucosa with local production of specific IgE [1,2,3,4,5]. Powe et al [6] enounced ‘entopy' by describing the activation of a Th2 immune response in the nasal mucosa of nonallergic rhinitis patients.…”

Is there any Correlation between the Results of Skin-Prick Test and the Severity of Symptoms in Allergic Rhinitis?

“…Recently, it has been shown that an important number of patients previously diagnosed as nonallergic rhinitis had local allergy with nasal production of specific IgE and a positive response to a nasal allergen provocation test. [16][17][18] This entity has been suggested to be atopy 16 or local allergic rhinitis. 19 Patients with local allergic rhinitis do not have atopy so we detected negative skin-prick tests and normal serum-specific IgE levels, but these patients have similar symptoms of allergic rhinitis.…”