Multiallergen nasal challenges in nonallergic rhinitis.
BACKGROUND
It has been proposed that some patients with nonallergic rhinitis may have "localized allergy" of the nasal mucosa. Nasal challenges with aeroallergens can help determine whether a patient is clinically allergic via an IgE-mediated pathway.


OBJECTIVE
To determine the prevalence of localized allergy in patients with negative skin prick test results via nasal challenges with an array of allergens.


METHODS
Twenty individuals with perennial rhinitis and negative epicutaneous test results to common perennial aeroallergens underwent nasal challenges to glycerin, Alternaria, cockroach, timothy grass, cat hair, and Dermatophagoides pteronyssinus. Total symptom scores, peak nasal inspiratory flow rates, and nasal eosinophil counts were determined.


RESULTS
Of 20 patients with nonallergic rhinitis, 4 were hyperresponsive to glycerin and were not subsequently challenged. Eleven patients had negative nasal challenges. Five patients developed positive challenges (total symptom score > or = 5) to 7 allergens. These 5 patients returned for nasal provocation testing to their offending allergens, and these repeated challenges were negative. Three control subjects with allergic rhinitis developed positive challenges after nasal allergen challenge.


CONCLUSIONS
Although some individuals with nonallergic rhinitis can have positive nasal allergen challenges, these results were not reproducible in the present patient population.
Wierzbicki
Dania A
DA
Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8859, USA.
Majmundar
Amee R
AR
Schull
Diane E
DE
Khan
David A
DA
D000328:Adult; D000485:Allergens / Q000008:administration & dosage / Q000276:immunology; D000528:Alternaria / Q000737:chemistry / Q000276:immunology; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000008:administration & dosage / Q000276:immunology; D002415:Cats; D002452:Cell Count; D003058:Cockroaches / Q000737:chemistry / Q000276:immunology; D004804:Eosinophils / Q000473:pathology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000276:immunology; D009299:Nasal Provocation Tests; D009666:Nose / Q000473:pathology / Q000503:physiopathology; D031784:Phleum / Q000737:chemistry / Q000276:immunology; D012220:Rhinitis / Q000175:diagnosis* / Q000276:immunology*; D012882:Skin Tests
D000485:Allergens; D039741:Antigens, Dermatophagoides