The Frequency of Local Allergic Rhinitis after Nasal Allergen Challenge

Introduction:

Local allergic rhinitis (LAR) is described as a phenotype of allergic rhinitis where no allergic sensitization in skin tests or in serum can be proven despite typical symptoms but nasal allergen challenge (NAC) is positive. Although LAR has been confirmed by several groups considerable ambiguity concerning its frequency and the best method for its validation remain.

Methods:

We investigated the frequency of LAR in all patients that received NAC in our department between 1993 and 2013 although no detection of allergic sensitization was found. NAC was performed using three increasing doses of allergen and otherwise the German guidelines for NAC werde followed.

Results:

We identified 153 patients with negative allergy tests. 71 of those were skin test negative as well as negative in serum specific IgE (sIgE); 79 had a negative skin test but no sIgE was measured, and 3 had negative sIgE and no skin test performed. In 22% of these patients (33/153) NAC was positive. In 15% of these (5/33) one of the two higher allergen concentrations was required for this result.

Conclusions:

In these 22% of our selected patients with symptoms of rhinitis LAR could be confirmed despite negative allergy tests. These data underline the clinical relevance of LAR and point to the importance of NAC even in patients where no allergic sensitization can be proven serologically and in skin tests.

No conflict of interest has been declared by the author(s).

Prof. Dr. med. Martin Wagenmann

HNO-Klinik Universität Düsseldorf,

Moorenstr. 5, 40225,

Düsseldorf,

Deutschland   

Email: [e-mail]

Publication History

Publication Date:
18 April 2018 (online)