TY - JOUR
T1 - Nonspecific hyper-reactivity and localized allergy
T2 - Cause of discrepancy between skin prick and nasal provocation test
AU - Chang, Geun Uck
AU - Jang, Tae Young
AU - Kim, Kyu Sung
AU - Choi, Hyuk
AU - Kim, Young Hyo
N1 - Funding Information:
Funding source: Grant from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A090084), data interpretation (statistical analysis) English interpretation and editing.
PY - 2014/2
Y1 - 2014/2
N2 - Objective. Disagreement between results of skin prick test (SPT) and nasal provocation tests (NPT) causes difficulty in differential diagnosis of allergic rhinitis (AR) and nonallergic rhinitis (NAR). We hypothesized this discrepancy could be due to the nonspecific hyper-reactivity (NHR) and localized allergy of the nasal cavity. Study Design. Prospective pilot. Setting. Academic tertiary rhinologic practice. Subjects and Methods. Sixty patients with AR and 62 with NAR were enrolled. We categorized patients according to results of SPT and NPT. We compared: (1) the clinical characteristics and severity of the disease, (2) change of minimal cross-sectional area (MCA) and total nasal volume (TNV) after normal saline (NS) challenge, and (3) change of nasal symptoms and acoustic parameters after intranasal house dust mite (HDM) challenge between groups. Results. Patients in groups A (SPT[1]/NPT[1]) and C (SPT[-]/ NPT[1]) complained of more persistent discomfort than those in groups B (SPT[1]/NPT[-]) and D (SPT[-]/NPT[-]). The proportion of moderate to severe symptoms was significantly higher in groups A, B, and C compared to group D. After NS challenge, MCA/TNV showed a significantly greater decrease in groups A (MCA: 27.6% 6 21.3%, TNV: 24.6% 6 16.4%) and C (MCA: 31.2% 6 24.0%, TNV: 24.1% 6 23.4%) compared to groups B (MCA: 0.1% 6 13.2%, TNV: 3.9% 6 13.5%) and D (MCA: 2.1% 6 12.1%, TNV: 2.0% 6 17.2%) (P < .05). After HDM challenge, groups A/B showed a greater decrease in MCA (Group A: 62.4% 6 16.1%, Group B: 6.4% 6 11.3%) compared to groups C/D (Group C: 45.5% 6 14.4%, Group D: -3.0% 6 9.5%). Conclusion. NHR and/or localized allergy should be considered in patients with rhinitis whose SPT and NPT results are not in agreement.
AB - Objective. Disagreement between results of skin prick test (SPT) and nasal provocation tests (NPT) causes difficulty in differential diagnosis of allergic rhinitis (AR) and nonallergic rhinitis (NAR). We hypothesized this discrepancy could be due to the nonspecific hyper-reactivity (NHR) and localized allergy of the nasal cavity. Study Design. Prospective pilot. Setting. Academic tertiary rhinologic practice. Subjects and Methods. Sixty patients with AR and 62 with NAR were enrolled. We categorized patients according to results of SPT and NPT. We compared: (1) the clinical characteristics and severity of the disease, (2) change of minimal cross-sectional area (MCA) and total nasal volume (TNV) after normal saline (NS) challenge, and (3) change of nasal symptoms and acoustic parameters after intranasal house dust mite (HDM) challenge between groups. Results. Patients in groups A (SPT[1]/NPT[1]) and C (SPT[-]/ NPT[1]) complained of more persistent discomfort than those in groups B (SPT[1]/NPT[-]) and D (SPT[-]/NPT[-]). The proportion of moderate to severe symptoms was significantly higher in groups A, B, and C compared to group D. After NS challenge, MCA/TNV showed a significantly greater decrease in groups A (MCA: 27.6% 6 21.3%, TNV: 24.6% 6 16.4%) and C (MCA: 31.2% 6 24.0%, TNV: 24.1% 6 23.4%) compared to groups B (MCA: 0.1% 6 13.2%, TNV: 3.9% 6 13.5%) and D (MCA: 2.1% 6 12.1%, TNV: 2.0% 6 17.2%) (P < .05). After HDM challenge, groups A/B showed a greater decrease in MCA (Group A: 62.4% 6 16.1%, Group B: 6.4% 6 11.3%) compared to groups C/D (Group C: 45.5% 6 14.4%, Group D: -3.0% 6 9.5%). Conclusion. NHR and/or localized allergy should be considered in patients with rhinitis whose SPT and NPT results are not in agreement.
KW - allergic rhinitis
KW - allergy
KW - nasal provocation tests
KW - nonspecific hyper-reactivity
KW - skin tests
UR - http://www.scopus.com/inward/record.url?scp=84893527052&partnerID=8YFLogxK
U2 - 10.1177/0194599813514512
DO - 10.1177/0194599813514512
M3 - Article
C2 - 24323906
AN - SCOPUS:84893527052
VL - 150
SP - 194
EP - 200
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
SN - 0194-5998
IS - 2
ER -