title: [Is prediction of the allergic march possible on the basis of nasal cytology?].
abstract: BACKGROUND
  The term allergic march has been used to describe natural evolution of the atopic disease in children, accompanied by the change in organ manifestation with time. The aim of the study was to analyze the role of the cellular components of the nasal cytology as a tool for prediction of atopic diseases and clinical symptoms preceding allergic march.
  
  
  METHODS
  In a retrospective manner out of a group of 1620 children, 146 symptomatic children (60 girls and 86 boys) meeting inclusion criteria (age below 4 years at first visit, symptoms suggesting allergy, nasal cytology performed at the beginning of observation, observation of at least 4 years) were included in analysis.
  
  
  RESULTS
  Mean age of children at time of enrollment was 27 months (SD 10 months). After 4 years allergic rhinitis (AR) was diagnosed in 85 children (58.2%), atopic eczema/dermatitis syndrome (AEDS) in 51 (34.9%) and asthma in 48 (32.9%). Nonallergic etiology was identified in 36 patients (22.5%). All patients with asthma suffered from AR. Significant differences between groups were found in number of eosinophils (p < 0.001), neutrophils (p < 0.001), and lymphocytes (p = 0.028) in cytological examination of nasal mucosa. In children with AR (alone or combined with other comorbidities) nasal eosinophilia was higher than in children with AEDS (18% v. 3%; p = 0.004) or non-allergic disease (18% v. 4%; p < 0.001). Nasal eosinophilia of at least 8% was predictive for development of AR (sensitivity 80%, specificity 95%).
  
  
  CONCLUSIONS
  In children below 4 years nasal eosinophilia >or= 8% was predictive for AR development. Allergic march was observed in children with AEDS or/and gastrointestinal allergy symptoms present at the beginning of observation. Nasal eosinophilia in small children might be predictive for the risk of allergic march.
authors.affiliation: Gabinet Alergologiczno-Pediatryczny, ul. Masarska 7/II, 31-534 Kraków. kiwer@oswirus.krakow.pl
authors.forename: Zygmunt
authors.initials: Z
authors.lastname: Nowacki
authors.forename: Jolanta
authors.initials: J
authors.lastname: Neuberg
authors.forename: Krystyna
authors.initials: K
authors.lastname: Strzałka
authors.forename: Magdalena
authors.initials: M
authors.lastname: Szczepanik
authors.forename: Renata
authors.initials: R
authors.lastname: Szczepanik
authors.forename: Henryk
authors.initials: H
authors.lastname: Mazurek
mesh_terms: D001491:Basophils / Q000166:cytology; D002648:Child; D002675:Child, Preschool; D003581:Cytodiagnosis; D004802:Eosinophilia / Q000453:epidemiology; D004804:Eosinophils / Q000166:cytology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D015999:Multivariate Analysis; D009297:Nasal Mucosa / Q000166:cytology / Q000473:pathology*; D009504:Neutrophils / Q000166:cytology; D011044:Poland; D011237:Predictive Value of Tests; D011379:Prognosis; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis* / Q000453:epidemiology; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis* / Q000453:epidemiology; D012720:Severity of Illness Index