Seung-No Hong1, Chae-Seo Rhee2,3,4,5, Joon Kon Kim1, Sue K Park6,7,8, Doo Hee Han9. 1. Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea. 2. Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 3. Graduate School of Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea. 4. Institute of Allergy and Clinical Immunology, Seoul National University Biomedical Research Center, Seoul, Republic of Korea. 5. Sensory Organ Research Institute, Seoul National University Biomedical Research Center, Seoul, Republic of Korea. 6. Department of Preventive Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 7. Department of Biomedical Science, Seoul National University Graduate School, Seoul, Republic of Korea. 8. Cancer Research Institute, Seoul National University, Seoul, Republic of Korea. 9. Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. handh@snu.ac.kr.
Abstract
PURPOSE: Allergic rhinitis (AR) is often defined based on symptoms accompanied by a positive allergen sensitivity test result. However, a positive skin prick test (SPT) does not always imply the occurrence of clinical symptoms. If an asymptomatic allergen-sensitized patient has nasal septal deviation (DSN) that could cause nasal obstruction, the condition could easily be confused with typical symptomatic AR. This study investigated the clinical and laboratory characteristics of asymptomatic allergen-sensitization with septal deviation (ASSD). METHODS: Patients from a nationwide AR cohort study, conducted in 8 university hospitals, were investigated. AR was diagnosed when there were at least 1 rhinitis symptom with a positive SPT result. The ASSD group included patients who had severe nasal obstruction with few other symptoms and a positive SPT, along with septal deviation. Clinical and laboratory characteristics were compared between the ASSD group and the true AR group. RESULTS: In total, 728 patients were included. The average age was 32.2 ± 12.7 and 66% of the patients had DSN. SPT indicated that ASSD patients were less sensitized to house dust mite (p = 0.019 for Dp and p = 0.021 for Df). There was a significant sex difference: the male-to-female ratio was higher in the ASSD than in the AR group (3.59 vs. 1.77, p = 0.012). However, no statistically significant differences in age, family history, and body mass index were found. CONCLUSION: ASSD can mimic AR. When dealing with allergen-sensitized patients with a predominant symptom of nasal obstruction, DSN might also be considered before confirming a diagnosis of AR.
PURPOSE:Allergic rhinitis (AR) is often defined based on symptoms accompanied by a positive allergen sensitivity test result. However, a positive skin prick test (SPT) does not always imply the occurrence of clinical symptoms. If an asymptomatic allergen-sensitized patient has nasal septal deviation (DSN) that could cause nasal obstruction, the condition could easily be confused with typical symptomatic AR. This study investigated the clinical and laboratory characteristics of asymptomatic allergen-sensitization with septal deviation (ASSD). METHODS:Patients from a nationwide AR cohort study, conducted in 8 university hospitals, were investigated. AR was diagnosed when there were at least 1 rhinitis symptom with a positive SPT result. The ASSD group included patients who had severe nasal obstruction with few other symptoms and a positive SPT, along with septal deviation. Clinical and laboratory characteristics were compared between the ASSD group and the true AR group. RESULTS: In total, 728 patients were included. The average age was 32.2 ± 12.7 and 66% of the patients had DSN. SPT indicated that ASSD patients were less sensitized to house dust mite (p = 0.019 for Dp and p = 0.021 for Df). There was a significant sex difference: the male-to-female ratio was higher in the ASSD than in the AR group (3.59 vs. 1.77, p = 0.012). However, no statistically significant differences in age, family history, and body mass index were found. CONCLUSION: ASSD can mimic AR. When dealing with allergen-sensitized patients with a predominant symptom of nasal obstruction, DSN might also be considered before confirming a diagnosis of AR.
Authors: A Verstege; A Mehl; C Rolinck-Werninghaus; U Staden; M Nocon; K Beyer; B Niggemann Journal: Clin Exp Allergy Date: 2005-09 Impact factor: 5.018
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Authors: Päivi M Salo; Agustin Calatroni; Peter J Gergen; Jane A Hoppin; Michelle L Sever; Renee Jaramillo; Samuel J Arbes; Darryl C Zeldin Journal: J Allergy Clin Immunol Date: 2011-02-12 Impact factor: 10.793