title: When sneezing indicates the cell type.
abstract: BACKGROUND
  Nasal hyperreactivity is the symptomatic expression of vasomotor rhinitis. This study describes a typical nasal reaction, represented by a "volley of sneezes" found in some patients during nasal endoscopy, and to assess the possible correlation between hyperreactivity and a particular clinical and cytological condition.
  
  
  METHODS
  We studied 671 rhinological subjects, 344 male, mean age 35.7 ± 13.76 standard deviation (SD) years. All were submitted to medical histories and clinical and instrumental investigations (skin prick test, nasal endoscopy, and nasal cytology). While performing endoscopy, particular attention was paid to the possible signs of nasal hyperreactivity, in particular "volley of sneezes" both during and immediately after the diagnostic procedure.
  
  
  RESULTS
  Out of 671 endoscopies performed, 130 (17.1%) patients presented signs of hyperreactivity during and/or immediately after nasal endoscopy. The ratio of positive vasomotor reaction was 10.6% in the nasal polyposis (NP) group, 19% in the allergic rhinitis (AR) group, 70.6% (p < 0.01) in nonallergic rhinitis with mast cells (NARMA), 76% (p < 0.01) in nonallergic rhinitis with eosinophils and mast cells (NARESMA), and 83% (p < 0.01) in nonallergic rhinitis with eosinophils (NARES). In the AR subjects hyperreactivity was more frequent during the pollen season, compared to the period of absence of pollen (87.5% vs 12%).
  
  
  CONCLUSIONS
  The onset of hyperreactivity (sneezing) can be considered an important "sign" in nasal symptomatology, whose sensitivity and specificity for nonallergic "cellular" rhinitis are 79% and 93%, respectively.
authors.affiliation: Section of Otolaryngology, Department of Neuroscience and Sensory Organs, University of Bari, Bari, Italy. gelardim@inwind.it
authors.forename: Matteo
authors.initials: M
authors.lastname: Gelardi
authors.forename: Nicola
authors.initials: N
authors.lastname: Quaranta
authors.forename: Giovanni
authors.initials: G
authors.lastname: Passalacqua
mesh_terms: D000328:Adult; D004804:Eosinophils / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000276:immunology*; D011058:Pollen / Q000009:adverse effects / Q000276:immunology; D011379:Prognosis; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology*; D012223:Rhinitis, Vasomotor / Q000175:diagnosis* / Q000276:immunology*; D012912:Sneezing / Q000276:immunology; D055815:Young Adult