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Rhinology 2019 Februrary 2
In recent years non-allergic rhinitis has received a lot of interest; in particular the different phenotypes, endotypes, the impact on quality of life and the potential role of IgE in local allergic rhinitis (LAR). The prevalence of LAR reported in the literature has been extremely variable (0-100%); Hamizan’s review in this issue explains many of these discrepancies. The overall prevalence of IgE in nasal secretion was found to be 10.2 (7.4-13.4) %. However, where there is history of an identifiable aeroallergen which triggered nasal symptoms or seasonality of symptoms, the prevalence is 19.8 (14.5- 25.6) %. On the other hand, patients who lacked a suggestive allergy history and had negative systemic allergy tests had zero probability of detectable nasal serum IgE (0 (0-3.1) %). This useful review highlights history taking as a simple method to filter potential LAR patients from the general NAR population. This is important because LAR patients significantly differ from other phenotypes of NAR, not only in terms of symptoms, but also the likelihood of developing asthma and susceptibility to treatment.
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