Value of clinical history, skin testing and nasal allergen challenge in the diagnose of perennial rhinopathia
Reinert, M.; Kiefer, R.
Laryngologie Rhinologie Otologie 55(6): 482-486
1976
ISSN/ISBN: 0340-1588 PMID: 135177 Document Number: 105515
In 64 out-patients suffering from perennial and partly from additional saisonal rhinopathia correlations between clinical history, skin testing (prick test) and nasal provocation tests were investigated. Most patients showed several positive skin tests to common allergens particular to grass pollen, house dust and mites (Dermatophagoides pteronyssimus). 123 nasal provocation tests were done. The correlation between history and skin test or nasal challenge was very strong for grass pollen (agreement in 78%), but very unsatisfctory for house dust and mites. Even in patients with positive skin tests to house dust and mites the history was only positive in 50-60%. Therefore the diagnose of perennial rhinopathia due to house dust and/or mites is only relevant if the nasal provocation gives a positive result. But if skin test are negative, nasal allergen challenge seldom showed positive reactions. For practical purpose nasal provocation is unneccessary if the skin test is negative. But the nasal provocation test don't give an absolutely right diagnose, because neither the environmental concentration nor the nasal threshold generally are known. Therefore, it is difficult to decide in many cases, if a reaction is positive because of testing a relevant allergen or because a latent allergen was overdosed. Finally the investigations show that simple and reproducible methods like the nasal forced expiratory volume in one second are sufficient to detect a positive nasal reaction.