title: [Diagnosis and clinical characteristics of patients with non-allergic rhinitis].
abstract: OBJECTIVE
  To explore a step-by-step exclusive diagnosis and analyze the clinical characters of non-allergic rhinitis (NAR).
  
  
  METHODS
  Patients with symptoms (nasal itching, sneezing, rhinorrhea, nasal congestion) were selected to take four-step exclusive diagnosis for NAR and we tried to eliminate the false NAR and retain the true NAR. First step was to exclude the patients who were not suitable for skin prick test (SPT, such as during pregnancy, breastfeeding, asthma, oral antihistamine medication in 7 day, severe skin diseases). The second step was to exclude the patients with positive SPT and the third step was to exclude the patients with 1 level or above of specific sero-immunoglobulin E (sIgE). The fourth step was to exclude the patients with infection rhinitis, clear abnormal nasal structure, drug-induced rhinitis, nasal neoplasm. The remained patients were finally diagnosed as NAR and who were further differential diagnosed as vasomotor rhinitis (VMR) or non-allergic rhinitis with eosinophilia syndrome (NARES) according to the eosinophilia counts in nasal secretion and venous blood. The common characters of patients with NAR were analyzed and their symptoms and quality of life were evaluated by visual analogue scale (VAS) and rhino-conjunctivitis quality of life questionnaire (RQLQ) separately.
  
  
  RESULTS
  One thousand four hundred and thirty-seven patients were included after first step exclusion and 735 cases with negative SPT were remained after second step exclusion. Of 735 patients, 302 were tested in vitro for sIgE and 93 cases with 0 level of sIgE and total IgE were remained after third step exclusion. Sixty-two patients were finally diagnosed as NAR after fourth step exclusion. The NAR diagnosis rate was 51.15% (735/1 437) with negative SPT alone and the NAR diagnosis rate was 29.06% (93/302) with combination of negative SPT and sIgE. Of 62 patients with NAR, 47 patients (75.81%) were diagnosed as VMR and 15 cases (24.19%) as NARES. There were 23 males and 39 females in the 62 patients aged 11 - 77 years. The history was 11-47 months. The biggest numbers of patients with VMR or NARES were among 41-50 years. Their onset ages were among 21-30 years in both two groups. VAS scores of nasal congestion in VMR patients were the highest with significant difference among nasal symptoms (F = 3.958 0, P = 0.009 1). VAS scores of sneezing in NARES patients were the highest but without significant difference among nasal symptoms. There were no difference in seven domain scores of RQLQ and the total mean scores between VMR group and NARES group but the nasal symptoms got the highest scores with significant difference among the seven domains in each group (VMR group, F = 9.771 2, P = 0.000 0;NRAES group, F = 3.226 9, P = 0.006 2).
  
  
  CONCLUSIONS
  SPT combined with sIgE may exclude much more patients with AR. Females with NAR are much more than males. Patients with NAR aged 21-30 years. The characters of NAR are helpful to improve our knowledge about NAR. VAS and RQLQ may be a suitable tool in assessment of NAR.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, the Chinese PLA General Hospital, Beijing 100853, China. Email: wht301@263.net.
authors.forename: Hongtian
authors.initials: H
authors.lastname: Wang
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.forename: Shaohua
authors.initials: S
authors.lastname: You
authors.forename: Yanyun
authors.initials: Y
authors.lastname: Ao
authors.forename: Yin
authors.initials: Y
authors.lastname: Bai
authors.forename: Huaiyin
authors.initials: H
authors.lastname: Shi
authors.forename: Lingchao
authors.initials: L
authors.lastname: Ji
authors.forename: Jingjie
authors.initials: J
authors.lastname: Jia
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhang
authors.forename: Hongxia
authors.initials: H
authors.lastname: Jia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000175:diagnosis; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012220:Rhinitis / Q000175:diagnosis*; D065631:Rhinitis, Allergic / Q000175:diagnosis; D012223:Rhinitis, Vasomotor / Q000175:diagnosis*; D012882:Skin Tests; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D007073:Immunoglobulin E