The Relevance of Nasal Provocation Testing in Children with Nonallergic Rhinitis. 2016

Handan Duman, and Ilknur Bostanci, and Serap Ozmen, and Mahmut Dogru
Department of Pediatric Immunology and Allergy, Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey.

BACKGROUND It is important to understand that allergic rhinitis, whether seasonal or perennial, may be difficult to distinguish clinically from the nonallergic forms of rhinitis. OBJECTIVE This study aimed to investigate the presence of local allergic rhinitis (LAR) in children who have allergic rhinitis symptoms in the absence of skin test positivity and specific IgE by performing a nasal provocation test (NPT). METHODS Our study followed a case-controlled, prospective design. Twenty-eight patients and 30 healthy children were included in the study in a pollen-free season. The NPTs with a grass mix, Dermatophagoides pteronyssinus (DP) and D. farinae (DF) allergens were performed with an interval of 1 week. The total symptom score and visual analog scale, nasal eosinophilia and pulmonary function tests were evaluated before and after each NPT. The change to nasal flow and resistance was recorded by anterior rhinomanometry. RESULTS The symptom frequencies before the NPTs were as follows: nasal congestion 100%; itching 82.1%; rhinorrhea 75% and sneezing 71.4%. The NPT was positive in 7 (25%) patients. In the NPT-positive group there was a statistically significant decrease in nasal flow at the concentrations of 10 and 100 IR/ml for DF (p = 0.026, p = 0.031, respectively). In the NPT-positive group total nasal resistance for DP was increased at the concentrations of 0.1 and 10 IR/ml, and for DF at 10 and 100 IR/ml (p = 0.049, p = 0.041, p = 0.022, p = 0.035, respectively). CONCLUSIONS We emphasize that the diagnosis of LAR should be taken into consideration by pediatricians and pediatric allergy specialists.

UI MeSH Term Description Entries
D007073 Immunoglobulin E An immunoglobulin associated with MAST CELLS. Overexpression has been associated with allergic hypersensitivity (HYPERSENSITIVITY, IMMEDIATE). IgE
D008297 Male Males
D009299 Nasal Provocation Tests Application of allergens to the nasal mucosa. Interpretation includes observation of nasal symptoms, rhinoscopy, and rhinomanometry. Nasal provocation tests are used in the diagnosis of nasal hypersensitivity, including RHINITIS, ALLERGIC, SEASONAL. Provocation Tests, Nasal,Nasal Provocation Test,Provocation Test, Nasal,Test, Nasal Provocation,Tests, Nasal Provocation
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D012220 Rhinitis Inflammation of the NASAL MUCOSA, the mucous membrane lining the NASAL CAVITIES. Nasal Catarrh,Catarrh, Nasal,Catarrhs, Nasal,Nasal Catarrhs,Rhinitides
D012882 Skin Tests Epicutaneous or intradermal application of a sensitizer for demonstration of either delayed or immediate hypersensitivity. Used in diagnosis of hypersensitivity or as a test for cellular immunity. Skin Test,Test, Skin,Tests, Skin

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