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Nasal eosinophilia in nasal smears of patients with persistent and intermittent allergic rhinitis

Published online by Cambridge University Press:  05 November 2018

G Berkiten
Affiliation:
ENT Clinic, Okmeydanı Training and Research Hospital, Istanbul, Turkey
İ Aydoğdu
Affiliation:
ENT Clinic, Okmeydanı Training and Research Hospital, Istanbul, Turkey
T L Kumral
Affiliation:
ENT Clinic, Okmeydanı Training and Research Hospital, Istanbul, Turkey
Z Saltürk
Affiliation:
ENT Clinic, Okmeydanı Training and Research Hospital, Istanbul, Turkey
Y Uyar
Affiliation:
ENT Clinic, Okmeydanı Training and Research Hospital, Istanbul, Turkey
A Arslanoğlu
Affiliation:
ENT Clinic, Okmeydanı Training and Research Hospital, Istanbul, Turkey
B Tutar*
Affiliation:
ENT Clinic, Okmeydanı Training and Research Hospital, Istanbul, Turkey
A E Göker
Affiliation:
ENT Clinic, Okmeydanı Training and Research Hospital, Istanbul, Turkey
*
Author for correspondence: Dr Belgin Tutar, ENT Clinic, Okmeydanı Training and Research Hospital, Darülaceze cad. Şişli/Istanbul, Turkey E-mail: [email protected]

Abstract

Background

Eosinophils are the principal effector cells involved in the pathogenesis of allergic rhinitis. Cell numbers increase in non-allergic rhinitis patients with eosinophilia, aspirin hypersensitivity and nasal polyposis, as well as in allergic rhinitis patients. Exfoliative nasal cytology can be used in the differential diagnosis of allergic rhinitis.

Objective

To evaluate nasal eosinophilia in nasal smears of patients with mild, persistent and intermittent allergic rhinitis.

Methods

The study comprised 60 patients with allergic rhinitis and 20 healthy volunteers. The patients were divided into intermittent and persistent allergic rhinitis groups. Nasal smear status, eosinophil numbers and Total Nasal Symptom Scores were compared.

Results

Nasal smear results were pathological in 40 of 60 allergic rhinitis patients, which was significantly higher than the rate in controls. The mean nasal eosinophilia score was significantly higher in the intermittent allergic rhinitis than in the persistent allergic rhinitis group (p = 0.029). There was a positive correlation between nasal eosinophilia score and Total Nasal Symptom Score (r = 0.652; p < 0.05) in persistent allergic rhinitis and intermittent allergic rhinitis patients.

Conclusion

The nasal smear test is inexpensive, objective and simple to perform, and should be part of the diagnostic investigation.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr B Tutar takes responsibility for the integrity of the content of the paper

References

1Simons, FE. Allergic rhinitis: recent advances. Pediatr Clin North Am 1988;35:1053–74Google Scholar
2Nalebuff, DJ. Allergic rhinitis. In: Cummings, CW, Fredrickson, JM, Harker, LA, Krause, CJ, Schuller, DE, eds. Otolaryngology Head and Neck Surgery, 2nd edn. St Louis: Mosby Year Book, 1993;765–74Google Scholar
3International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet 1998;351:1225–32Google Scholar
4Liu, F, Zhang, J, Liu, Y, Zhang, N, Holtappels, G, Lin, P et al. Inflammatory profiles in nasal mucosa of patients with persistent vs intermittent allergic rhinitis. Allergy 2010;65:1149–57Google Scholar
5Bousquet, J, Khaltaev, N, Cruz, AA, Denburg, J, Fokkens, WJ, Togias, A et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008;63(suppl 86):8160Google Scholar
6Özgür, A, Arslanoğlu, S, Etıt, D, Demıray, U, Önal, HK. Comparison of nasal cytology and symptom scores in patients with seasonal allergic rhinitis, before and after treatment. J Laryngol Otol 2011;125:1028–32Google Scholar
7Salas, A, Wilson, N, Hamburger, RN. Relation of serum IgE level to the cells observed in the nasal cytograms. Ann Allergy 1988;60:175Google Scholar
8Lu, D, Zhao, Y, Zheng, Y, An, P, Wang, L, Qiao, X et al. Evaluation of quality of life questionnaires for adult patients with moderate to severe allergic rhinitis. Am J Otolaryngol 2011;32:494–8Google Scholar
9Jalowayski, A, Zeiger, RS. A Practical Guide for the Examination of Nasal Cytology in the Diagnosis of Nasal Disorders. San Diego: University of California, 1980Google Scholar
10Cohen, SG, Ottesen, EA. The eosinophil, eosinophilia, and eosinophil-related disorders. In: Middleton, E Jr, Reed, CE, Ellis, EF, eds. Allergy: Principles and Practice, 2nd edn. St Louis: CV Mosby, 1983;701Google Scholar
11Crobach, M, Hermans, J, Kaptein, A, Ridderikhoff, J, Mulder, J. Nasal smear eosinophilia for the diagnosis of allergic rhinitis and eosinophilic non-allergic rhinitis. Scand J Prim Health Care 1996;14:116–21Google Scholar
12Skoner, DP. Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. J Allergy Clin Immunol 2001;108(1 suppl):S28Google Scholar
13Boyce, JA, Broide, D, Matsumoto, K, Bochner, BS. Advances in mechanisms of asthma, allergy, and immunology in 2008. J Allergy Clin Immunol 2009;123:569–74Google Scholar
14Prussin, C, Metcalfe, DD. 5. IgE, mast cells, basophils, and eosinophils. J Allergy Cln Immunol 2006;117(2 suppl mini-primer):S450–6Google Scholar
15Sood, A. Diagnostic significance of nasal eosinophilia in allergic rhinitis. Indian J Otolaryngol Head Neck Surg 2005;57:1316Google Scholar
16Lans, DM, Alfano, N, Rocklin, R. Nasal eosinophilia in allergic and nonallergic rhinitis: usefulness of the nasal smear in the diagnosis of allergic rhinitis. Allergy Proc 1989;10:275–80Google Scholar
17Burrows, B, Hasan, FM, Barbee, RA, Halonen, M, Lebowitz, MD. Epidemiologic observations on eosinophilia and its relation to respiratory disorders. Am Rev Respir Dis 1980;122:709–19Google Scholar
18Jankowski, R, Persoons, M, Foliguet, B, Coffinet, L, Thomas, C, Verient-Montaut, B. Eosinophil count in nasal secretions of subjects with and without nasal symptoms. Rhinology 2000;38:2332Google Scholar
19Gelardi, M, Fiorella, ML, Russo, C, Fiorella, R, Ciprandi, G. Role of nasal cytology. Int J Immunopathol Pharmacol 2010;23(1 suppl):45–9Google Scholar
20Ahmadiafshar, A, Taghiloo, D, Esmailzadeh, A, Falakaflaki, B. Nasal eosinophilia as a marker for allergic rhinitis: a controlled study of 50 patients. Ear Nose Throat J 2012;91:122–4Google Scholar
21Nurkic, J, Ahmad, MA, Arifhodzic, N, Jusufovic, E. The role of target organ diagnostic approach in seasonal allergic rhinitis: nasal smear eosinophils. MaterSociomed 2016;28:125–8Google Scholar
22Bryan, MP, Bryan, WT. Cytologic diagnosis in allergic disorders. Otolaryngol Clin North Am 1974;7:637–66Google Scholar
23Malmberg, H, Holopainen, E. Nasal smear as a screening test for immediate-type nasal allergy. Allergy 1979;34:331–7Google Scholar
24Vaheri, E. Nasal allergy with special reference to eosinophilia and histopathology. Acta Allergol 1956;10:203–11Google Scholar
25Bhandari, CM, Baldwa, VS. Relative value of peripheral blood, secretion and tissue eosinophilia in the diagnosis of different patterns of allergic rhinitis. Ann Allergy 1976;37:280–4Google Scholar
26Okano, M, Nishizaki, K, Nakada, M, Kawarai, Y, Goto, S, Satoskar, AR et al. Prevalence and prediction of allergic rhinitis using questionnaire and nasal smear examination in schoolchildren. Acta Otolaryngol Suppl 1999;540:5863Google Scholar
27Perić, A, Vojvodić, D, Vukomanović-Durdevid, B. Influence of allergy on clinical, immunological and histological characteristics of nasal polyposis. B-ENT 2012;8:2532Google Scholar