The Distinguishing Clinical Features of Nonallergic Rhinitis Patients

Background Not all rhinitis patients are affected by an immunoglobulin E (IgE)-mediated inflammatory process. Skin and serum allergy assessments are limited in their ability to define local allergic rhinitis (LAR). Thus, patients with negative systemic allergy assessments comprise a mix of those who truly have nonallergic rhinitis (NAR) and patients with LAR. Objective To determine the clinical characteristics of patients with NAR. Methods A cross-sectional study was performed on consecutive adults with rhinitis symptoms who underwent turbinate surgery. NAR patients were defined by excluding allergy using both systemic (serum-specific IgE and/or skin prick test) and local (inferior turbinate tissue-specific IgE) tests. Allergic rhinitis (AR) patients were defined by any positive systemic or local test toward aeroallergens. The clinical characteristics studied included allergic comorbidities (asthma, eczema, allergic conjunctivitis), inhalant allergen triggers (dust, pollen, animal dander), and environmental triggers (Cincinnati Irritant Index [CII]). Results There were 154 participants (41.79 ± 14.78 years, 37.7% female). NAR patients (11.7%) were older (49.33 ± 15.99 vs 40.78 ± 14.38 years, P = .02), had less self-reported asthma (5.6% vs 36.3%, P < .01) and house dust inhalant trigger (38.9 vs 65.2%, P = .03) compared to AR patients. The CII score was similar for NAR and AR (31.06 ± 28.88 vs 35.49 ± 24.70, P = .61). Conclusion Patients who were older, without asthma, and lacked an inhalant allergy trigger were more likely to have true NAR. Environmental triggers are not distinguishing features of NAR. This may be used as a guide to identify rhinitis patients whose symptoms are truly nonallergic etiology compared to those with falsely negative systemic allergy assessment but may still need management for LAR.

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Association between Allergic Rhinitis and Regular Physical Activity in Adults: A Nationwide Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165662 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5662

Author(s):

Jewel Park ◽

Joo Hee Park ◽

Jaehyung Park ◽

Jimi Choi ◽

Tae Hoon Kim

Keyword(s):

Physical Activity ◽

Allergic Rhinitis ◽

Immunoglobulin E ◽

Adult Population ◽

Specific Ige ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

General Adult Population ◽

Using Data

Evidence regarding the association between allergic rhinitis (AR) and physical activity (PA) is conflicting. Previous studies have mostly relied only on self-reported symptoms to define AR, did not classify AR by severity or persistence, and included only children or athletes. The present cross-sectional study evaluated the association between PA and objectively-defined AR and its subtypes in the general adult population using data for 1932 eligible participants aged 19 years or older in the 2010 Korea National Health and Nutrition Examination Survey. Multivariable logistic regression analyses were performed to evaluate the relationship between three types of PA and overall AR, AR subtypes, and rhinoscopy findings showed that moderate-severe AR was positively associated with vigorous (odds ratio [OR] = 3.392, p = 0.002) and moderate (OR = 3.623, p = 0.007) PA compared to mild AR, while persistent AR was associated with vigorous (OR = 3.954, p = 0.004) and moderate (OR = 3.411, p = 0.022) PA compared to intermittent AR. On rhinoscopy, vigorous PA was significantly associated with watery rhinorrhea (OR = 2.203, p = 0.048) but not pale mucosa. Total immunoglobulin E (IgE) and three allergen-specific IgE were not significantly elevated in participants who performed PA. Therefore, regular vigorous PA is associated with subjective and objective aggravation of AR symptoms, which may not necessarily manifest as increased serum IgE levels.

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Prevalence and Risk Factors of Allergic Bronchopulmonary Aspergillosis and Aspergillus Sensitization in Children with Poorly Controlled Asthma

Journal of Tropical Pediatrics ◽

10.1093/tropej/fmz066 ◽

2019 ◽

Vol 66 (3) ◽

pp. 275-283

Author(s):

Jyoti Kumari ◽

Kana Ram Jat ◽

Rakesh Lodha ◽

Manisha Jana ◽

Immaculata Xess ◽

...

Keyword(s):

Risk Factors ◽

Immunoglobulin E ◽

Care Center ◽

Tertiary Care ◽

Allergic Bronchopulmonary Aspergillosis ◽

Specific Ige ◽

Cross Sectional Study ◽

High Resolution Computed Tomography ◽

Cross Sectional ◽

Prick Test

Abstract Background Allergic bronchopulmonary aspergillosis (ABPA) may be a risk factor for poorly controlled asthma in children. The studies regarding prevalence and risk factors of ABPA in children with poorly controlled asthma are limited in number. Objectives To determine prevalence and risk factors of ABPA and aspergillus sensitization (AS) in children with poorly controlled asthma. Methods In this prospective cross-sectional study from a tertiary care center in India, we enrolled asthmatic children 5–15 years of age with poorly controlled asthma. We did the following investigations: spirometry, skin prick test, serum total immunoglobulin E (IgE), aspergillus-specific IgE and immunoglobulin G, serum precipitin for Aspergillus, absolute eosinophil count, chest X-ray and high-resolution computed tomography of the chest. ABPA and AS were diagnosed as per the recently proposed criteria. Results We enrolled 106 children [boys 72 (67.9%); mean age of 10.2 ± 2.6 years] with poorly controlled asthma. The prevalence of ABPA and AS were 11.3% (95% CI, 5.2–17.5%) and 61.3% (95% CI, 52.0–70.7%), respectively. The presence of brownish sputum was significantly more in ABPA compared with non-ABPA patients (33.3 vs. 4.2%, p = 0.002). The age, gender, allergic rhinitis and gastroesophageal reflux were not significantly different in ABPA compared with non-ABPA patients. Conclusion The prevalence of ABPA and AS was 11.3 and 61.3%, respectively in children with poorly controlled asthma. We could not find any risk factors for ABPA except that the presence of brownish sputum was more in children with ABPA. Spirometry parameters were not significantly different in ABPA compared with non-ABPA patients.

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Serum specific IgE responses to inhalant allergens sensitization

Medical Journal of Indonesia ◽

10.13181/mji.v26i3.1909 ◽

2017 ◽

Vol 26 (3) ◽

pp. 224-8

Author(s):

Iris Rengganis ◽

Suriani Alimuddin ◽

Agus J. Susanto

Keyword(s):

Immunoglobulin E ◽

Specific Ige ◽

Cross Sectional Study ◽

Positive Skin Prick Test ◽

Dust Mites ◽

Storage Mites ◽

Cross Sectional ◽

Positive Skin ◽

Prick Test ◽

Inhalant Allergens

Background: Serum specific immunoglobulin E (ssIgE) sensitization to common inhalant allergens has not been studied in Indonesia. This study aimed to evaluate specific IgE production of common inhalant allergens in patients with asthma and/or allergic rhinitis in Jakarta, Indonesia.Methods: This was a cross-sectional study in adult patients with respiratory allergy from September to December 2016 at Cipto Mangunkusumo Hospital, Jakarta. Patients were included if they showed at least one positive skin prick test (SPT) to environmental allergens. Serum specific IgE was assayed by using multiple allergosorbent methods. Inhalant allergens tested were dust mites, pollen, cockroach, animal dander, and mould. Serum IgE level more than 0.35 kU/L was considered positive.Results: One hundred subjects were enrolled (76% women). Dust mites made up 75% of sensitization, followed by cat/dog (31%), cockroach (27%), pollen (24%), and mould (6%). Almost all patients sensitized to cockroach, pollen, cat/dog epithelia and mould were also co-sensitized with dust mites. Twenty two percent of patients were negative to all tested allergens.Conclusion: IgE-sensitization to inhalant allergens varies widely in respiratory allergic patients. House dust and storage mites are the most common allergens. About one-fifth of the subjects did not show specific-IgE sensitization. Thus, this test should always be combined with SPT to diagnose allergy.

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Allergic rhinitis, part of the allergic respiratory syndrome

Medicinski pregled ◽

10.2298/mpns2010301a ◽

2020 ◽

Vol 73 (9-10) ◽

pp. 301-308

Author(s):

Aleksandra Aleksic ◽

Mirjana Gnjatic ◽

Mirjana Stupar-Hofman ◽

Vesna Tomic-Spiric

Keyword(s):

Allergic Rhinitis ◽

Chronic Rhinosinusitis ◽

Immunoglobulin E ◽

Otitis Media With Effusion ◽

Systemic Disease ◽

Positive Family History ◽

Cross Sectional Study ◽

Cross Sectional ◽

Statistical Analysis System ◽

Analysis System

Introduction. Diseases associated with immunoglobulin E hypersensitivity, such as allergic rhinitis, may have different clinical expressions. Patients with allergic rhinitis often have associated diseases, comorbidities, which supports the concept of allergy as a systemic disease. The aim of this study was to evaluate the incidence and types of comorbidities in allergic rhinitis. We also evaluated the possible effects of certain clinical and demographic parameters on the onset of comorbidities. Material and Methods. This retrospective, observational, and cross-sectional study included patients with a clinical diagnosis of allergic rhinitis treated at the Department of Ear, Nose and Throat in the period from October 2011 to April 2013. The collected data were analyzed using the Statistical Analysis System (Institute Inc. NC, USA) program, version 9.1.3. Results. The study included 319 patients with allergic rhinitis. Allergic rhinitis was intermittent in 30.7% of cases, persistent in 37.9%, and persistent with seasonal exacerbation in 31.3% of patients. We found that 86.8% of patients had some form of comorbidity. The most common were conjunctivitis (50.2%), almost equal percentage of asthma (29.8%) and chronic rhinosinusitis (28.8%), followed by otitis media with effusion (8.8%), atopic dermatitis (5.2%), urticaria (4.1%), and laryngitis (3.8%). Persistent allergic rhinitis, with persistent nasal obstruction as the dominant symptom, was significantly associated with chronic rhinosinusitis. Positive family history was significantly associated with the occurrence of asthma and allergic rhinitis. Conclusion. The results of our study showed that allergic rhinitis is rarely an isolated condition and it should always be observed in the context of the allergic respiratory syndrome.

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KAITAN IgE SPESIFIK METODE IMUNOBLOT TERHADAP ELISA PADA RINITIS ALERGI

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v21i3.744 ◽

2016 ◽

Vol 21 (3) ◽

pp. 298

Author(s):

Aryati Aryati ◽

Dwi Retno Pawarti ◽

Izzuki Muhashonah ◽

Janti Tri Habsari

Keyword(s):

Allergic Rhinitis ◽

Correlation Coefficient ◽

Sensitivity And Specificity ◽

Clinical Signs ◽

Specific Ige ◽

Total Serum ◽

Inhalant Allergen ◽

Elisa Method ◽

Cross Sectional ◽

Prick Test

Allergic rhinitis is an allergic disease that is most often found beside bronchial asthma and eczema with the prevalence of is about 33.3%, 9.8% and 11.2% respectively. The main examinations of allergic rhinitis are Skin Prick Test (SPT) and specific IgE, becausethe sensitivity and specificity of specific IgE examination depend on the examination method. To know the diagnostic value of specific IgE immunoblot examination by determination and were compared with ELISA in patients with allergic rhinitis. The cross-sectional design of the study is con-ducted on patients at the Outpatient Clinic Department of ENT-Head and Neck from May until October 2014. Patients were grouped as diagnosis of allergic rhinitis and non-allergic non-infectious rhinitis based on clinical signs and symptoms, physical examina-tion, positive in SPT examination with or without an increase in total serum IgE and/or blood eosinophils. Specific IgE immunoblot was conducted by using Foresight®, Acon Laboratories and the ELISA method using Allercoat™. The sensitivity and specificity of inhalant allergen -specific IgE immunoblot Foresight® method was 73.9% and 42.9%, respectively. The sensitivity and specificity of inhalant allergen -specific IgE ELISA method was 67.4% and 57.1%, respectively. The results of these two methods have a correlation coefficient 0.531 with p=0.000. The sensitivity and specificity of ingestan allergen specific IgE immunoblot Foresight® method was 41.3% and 85.7%, respectively. The sensitivity and specificity of ingestan allergen specific IgE ELISA method was 17.4 and 78.6%, res-pectively. Results of these two methods have a correlation coefficient 0.375 with p=0.003. Based on this study of specific IgE immunoblot and ELISA methods, both have diagnostic sensitivity and specificity, which are almost the same. The sensitivity of immunoblot method inhalant allergens are superior to ELISA. The Immunoblot method ingestan allergen specificity is superior to ELISA.

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Cut-off value of D. pteronyssinus specific IgE in double negative patients Der p 1 and Der p 2 and its clinical repercussion

Scientific Reports ◽

10.1038/s41598-021-03005-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Antonio Letrán ◽

Ignacio García ◽

Marisa Espinazo-Romeu ◽

Carmen Moreno-Aguilar ◽

Francisco Moreno

Keyword(s):

Roc Curves ◽

Specific Ige ◽

Diagnostic Techniques ◽

Cross Sectional Study ◽

Double Negative ◽

Double Positive ◽

Cross Sectional ◽

Prick Test ◽

Der P 1 ◽

Der P 2

AbstractAccessibility to more precise diagnostic techniques such as component resolved diagnostics (CRD), provides us with an important advance in diagnostic aspects as well as treatment. The subject of this study aims to better understand the profiles of sensitization to Der p 1, Der p 2 and Der p 23 and to know to what extent their use could help us in optimizing the decision-making for their treatment with Specific Immunotherapy. Cross-sectional study of subjects older than 5 years, diagnosed with allergy to HDM using skin prick test and sIgE, with symptoms of rhinitis and/or asthma. Total and specific IgE was determined to D. pteronyssinus, nDer p 1, rDer p 2 and rDer p 23 using ImmunoCAP. 240 patients were recruited (97.1% rhinitis and 46.25% rhinitis and asthma). Four different phenotypes were observed: positive or negative for sIgE nDer p 1 and/or IgE rDer p 2. 17% of these patients sIgE were double negative for Der p 1 and Der p 2 (increasing with age and with significantly lower sIgE levels than the rest of the groups). Using ROC curves, value less than 2.18 KUA/L for D. pteronyssinus sIgE gave us a sensitivity and specificity of 0.882 and 0.985, respectively, to double negative IgE nDer p 1 and IgE rDer p 2 group. Despite positive SPT and sIgE to D. pteronyssinus, 17% of the studied population is IgE nDer p 1 and IgE rDer p 2 double negative, with a cut-off value of 2.18 KU/L, which is very relevant for taking of decisions in prescription of AIT. The double positive population sIgE nDer p 1 and IgE rDer p 2 is associated with asthma compared to the other groups and this does not seem to be influenced by IgE rDer p 23.

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The study of correlation between clinical history of allergic rhinitis and result of skin prick test in allergic rhinitis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200507 ◽

2020 ◽

Vol 6 (3) ◽

pp. 466

Author(s):

Reena Anil Vare ◽

Shradha Jaydhaval Karkamkar

Keyword(s):

Allergic Rhinitis ◽

Skin Prick Test ◽

Immunoglobulin E ◽

Skin Prick Testing ◽

Test Procedure ◽

Common Symptom ◽

Type I ◽

Age Group ◽

Cross Sectional ◽

Prick Test

Background: Allergic rhinitis is a recurrent or chronic allergen specific type I hypersensitivity disorder. Skin prick testing is an essential test procedure to confirm sensitization in immunoglobulin E mediated allergic diseases presenting with allergic rhinitis.Methods: The present study was a hospital based cross sectional comparative study. Tests were applied to volar aspect of forearm, at least 2-3 cm from the wrist. 56 allergens were tested on patient`s body as the allergist watches for signs of an allergic skin reaction. The negative (-), positive (+), (+++) and (++++) results were assessed. Results: Out of 100 study subjects, most of the study subjects were from age group 31-40 years of age (46%) followed by 41-50 (30%). Very few i.e. 3% were less than 19 years of age. Out of total majority were male (57%) and 43% were female. Most of the females were from age group 31-40 i.e. 26%. Sensitivity of the skin prick test was 89.01% and specificity was 100%.Conclusions: Skin prick test is a very sensitive test to diagnose allergens. Sneezing was the most common symptom and dust was the most common aero-allergen found.

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Skin prick test reactivity in atopic children and their number of siblings

Paediatrica Indonesiana ◽

10.14238/pi55.4.2015.189-93 ◽

2015 ◽

Vol 55 (4) ◽

pp. 189

Author(s):

Beatrix Siregar ◽

Lily Irsa ◽

Supriatmo Supriatmo ◽

Sjabaroeddin Loebis ◽

Rita Evalina

Keyword(s):

Skin Prick Test ◽

Specific Ige ◽

Cross Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Positive Skin ◽

Prick Test ◽

Group I ◽

History Of ◽

Skin Prick Tests

Background Some studies have shown that low birth order is a risk factor for developing atopy, although these results remain inconclusive. Those studies put forth the hygiene hypothesis, which states that early childhood infections in siblings may protect against atopy. Hence, an inverse relationship between family numbers and atopy was found. Atopy may be diagnosed from a history of atopy in an individual or his family, and can be confirmed by specific IgE for allergens or positive skin prick tests.Objective To assess for an association between skin prick test reactivity in atopic children and their number of siblings.Methods A cross-sectional study was conducted in May to June 2010 in elementary school children at the Kampung Baru District, Medan Regency, North Sumatera. Subjects were divided into two groups. Group I had children with < 3 siblings and group II had children with ≥ 3 siblings. Skin prick tests were done in 7 to 10-year-old children with a history of asthma, allergic rhinitis and atopic dermatitis. Skin prick test reactivity results were analyzed by Chi-square test.Results A total of 192 subjects were enrolled in this study, with 96 subjects in each group. Positive skin prick tests were significantly higher in subjects with <3 siblings than in those with >3 siblings (75% and 53.1%, respectively; P=0.003).Conclusion Atopic children with <3 siblings had more positive skin prick tests than children with >3 siblings.

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Serum allergen-specific IGE to common aeroallergens among allergic rhinitis patients in Egypt

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00118-5 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Hossam Moustafa Elkady ◽

Ahmed Atef

Keyword(s):

Allergic Rhinitis ◽

Specific Ige ◽

Cross Sectional Study ◽

Dermatophagoides Pteronyssinus ◽

Cross Sectional ◽

Allergic Rhinitis Patient ◽

Positive Serum ◽

Allergen Sources ◽

Inhalant Allergens ◽

Animal Dander

Abstract Background Allergic rhinitis is the most prevalent allergic disease, and the prevalence and sensitization patterns differ among countries. Identifying the most common inhalant allergen in each region plays a key role in the diagnosis and management of allergic rhinitis. There are no data available about the most prevalent aeroallergen among allergic rhinitis patients in Egypt. The aim of this study is to evaluate the prevalence of positive serum allergen-specific IGE to common inhalant allergens among allergic rhinitis patients in Egypt. A cross-sectional study was conducted on 354 allergic rhinitis patients, serum allergen-specific IGE was measured by using the Immuno CAP system to 16 common regional aeroallergens including (pollens, mite, molds, animal dander, and cockroach). Results The overall rate of sensitization to any allergen was 74.6%. Dermatophagoides pteronyssinus, birch pollens, and Dermatophagoides farina were the most prevalent allergens (29.7%, 23.7%, and 18.6%), respectively. Cladosporuim molds were the least prevalent individual allergens (1.7%). Conclusion Our data suggest that Dermatophagoides pteronyssinus and birch pollens were the predominant allergen sources among allergic rhinitis patient in Egypt.

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Baked Tolerance in Cow’s Milk Allergy: Quite Frequent, Hard to Predict!

International Archives of Allergy and Immunology ◽

10.1159/000511148 ◽

2020 ◽

pp. 1-5

Author(s):

Lisis Karine Vilar ◽

Flávia Alves Araújo ◽

Thalita Pereira Santos ◽

Thatiana Tavares Menezes ◽

Marina F. Cheik ◽

...

Keyword(s):

Food Challenge ◽

Specific Ige ◽

Cross Sectional Study ◽

Cow’S Milk ◽

Cross Sectional ◽

Prick Test ◽

Cow's Milk ◽

Baked Goods ◽

Baked Foods ◽

Baked Milk

Introduction: Cow’s milk protein allergy (CMA) is the most common type of food allergy in childhood and exclusion diet is a challenge for patients. Objective: The study aim was to investigate the frequency of tolerance to baked foods containing milk and evaluate immediate skin prick test (SPT) and specific IgEs for different cow’s milk (CM) protein types as predictors of tolerance to baked foods containing milk for CMA patients. Methods: A cross-sectional study was performed. Fifty-four CMA patients were enrolled and oral food challenge (OFC) was performed with baked product, 6 different milk SPTs and specific IgEs to CM, casein, α-lactalbumin, and β-lactoglobulin. Results: Thirty-nine (72.2%) patients tolerated OFC with baked milk cupcake. CM-specific IgE and casein SPT showed statistical difference between positive and negative OFC groups. Probability curves for baked milk tolerance were created for specific CM IgE (Z = 2.542, p < 0.0110) and casein SPT (Z = 2.290, p < 0.0220) using logistic regression. Conclusions: The high percentage of patients able to tolerate baked goods enables an improvement in intake possibilities and quality of life of CMA patients and families. Specific CM IgE and casein SPT demonstrated to be useful predictors in relation to baked milk tolerance.

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