33 research outputs found
Contribution of Neurogenic and Allergic Ways to the Pathophysiology of Nonallergic Rhinitis
No full textBackground: A neuroallergic interaction was reported in the pathogenesis of allergic rhinitis (AR), but the pathophysiology of nonallergic rhinitis (NAR) is poorly understood. We aimed to explore the contribution of neuroallergic mechanisms to the pathogenesis of NAR. Methods: Subjects were divided into three groups - NAR patients (n = 25), AR patients (n = 16) and the control group (n = 10) - and were assessed using the nasal provocation test (NPT) with house dust mite. Total symptom scores, nasal inspiratory peak flow and nasal lavage were performed before and after NPT. Nasal brushing and scraping was done after NPT. Results: NPT was positive in NAR (52%) and AR (100%) patients and negative in all controls. After NPT, total symptom scores increased in both rhinitis groups. Post-NPT values of nasal inspiratory peak flow decreased only in AR patients. NAR patients showed a similar inflammatory cell profile in the nasal smears to AR patients which was different in controls. There were more tryptase- and immunoglobulin E (IgE)-positive cells in the nasal mucosa of AR patients, and more substance-p-positive cells were observed in NAR patients compared with controls. However, IgE- and tryptase-positive cells in NAR patients and substance-p-positive cells in AR patients were detectable in nasal mucosa, but rarely in the controls. Comparing the values before and after NPT, tryptase significantly increased in the nasal lavages of AR and NAR patients, while house dust mite-specific IgE did not change. Conclusions: We showed the existence of a common pathophysiological mechanism with different contributions in AR and NAR. We conclude that the difference in dominance of neuroallergic ways may determine the major phenotype of rhinitis. Copyright (C) 2012 S. Karger AG, BaselKirikkale University Projects of Scientific ResearchesKirikkale University [2007/4]This work was supported by a grant from Kirikkale University Projects of Scientific Researches (grant No. 2007/4) which was received by Baccioglu Kavut and Fusun Kalpaklioglu
Does Serum Leptin Differ Between Patients With Rhinitis Of Allergic Vs Nonallergic Aetiology?
No full textAnnual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology (AAAAI) -- FEB 28-MAR 04, 2014 -- San Diego, CA…Amer Acad Allergy Asthma & Immuno
Diagnostic tools for allergic rhinitis and asthma
No full textThe diagnosis of allergic airway diseases is based on symptoms, and the laboratory tests help us to classify the types. A correct diagnose is important, since the treatment will change in different types of diseases. For example, untreated rhinitis may result in other diseases like asthma, and deteriorate the quality of life. Therefore, early diagnosis of allergic airway diseases is important before the disease progresses. This review summarizes the currently known diagnostic tools which can be useful in daily practical life and researches, including assessment of symptoms, physical examination, allergy skin tests, total and specific IgE, nasal provocation test and assessment parameters (symptoms, nasal flow and secretions), nasal mucosal sampling, and pulmonary function test
Comparison of azelastine versus triamcinolone nasal spray in allergic and nonallergic rhinitis
No full text65th Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology -- MAR 13-17, 2009 -- Washington, DCBackground: Intranasal antihistamine has not been thoroughly studied in the treatment of rhinitis of different etiologies. This study was designed to show the comparative efficacy of nasal antihistamine and nasal corticosteroid in patients with allergic rhinitis (AR) and nonallergic rhinitis (NAR). Methods: A comparison of the efficacy of azelastine nasal spray (AZENS) versus triamcinolone acetonide nasal spray (TANS) on total nasal symptom scores (TNSS), nasal peak inspiratory flow rate (nPIFR), and nasal cytology was studied in a 2-week randomized parallel-group trial. The Epworth Sleepiness Scale (ESS) and health-related quality of life (HRQoL) were also analyzed. Results: The study group consisted of 132 patients (100 women and 32 men) with a mean age of 33.14 +/- 12.52 years, Sixty-nine patients had AR and 63 had NAR. Although TNSS including sneezing, itching, rhinorrhea, congestion-but not anosmia-significantly improved in both groups, intranasal azelastine reduced ocular symptoms greatly compared with intranasal triamcinolone (p = 0.05). Patients with NAR seemed to respond more to TANS, whereas AZENS was more useful in AR. The nPIFR improved in AR and NAR, with no significant difference between the treatment groups. Neither intranasal azelastine nor intranasal triamcinolone changed cytology in nasal lavage. Both medications were well tolerated, but AZENS led to more adverse events than TANS (56.9 and 19%, respectively; p = 0.001), mainly because of bitter taste. Scores on each domain of generic HRQoL (36-Item Short-Form Health Survey) and mini-rhinitis QoL questionnaires, as well as ESS score, significantly improved in both groups, irrespective of rhinitis etiology. Conclusion: In this first comparative demonstration, AZENS appears to be as effective as triamcinolone in symptom scores, nPIFR, ESS, and HRQoL, equally in AR and NAR. (Am J Rhinol Allergy 24, 29-33, 2010; doi: 10.2500/ajra.2010.24.3423)Amer Acad Allergy Asthma & Immunol (AAAAI
Characteristics of nonallergic rhinitis
No full textNonallergic rhinitis (NAR) is a type of rhinitis with perennial symptoms, unknown aetiology, and no clear treatment suggestions. Even though NAR has similarities with allergic rhinitis with regards to its prevalence, symptoms and impairment on quality of life, its importance is underestimated in clinical practice. There is no single valid test for the diagnosis of NAR as typical rhinitis symptoms, negativity in allergy skin tests and/or specific IgE, and exclusion of nonallergic rhinitis types with known aetiology are required. Pathophysiology of NAR is poorly understood, but a key component involves activation of neurogenic or allergic pathways. The aim of this review was to describe the characteristics, diagnostic methods, prevalence, pathophysiology, and treatment of NAR in the light of recent publications
False-positive PET-CT scan secondary to interstitial pneumonitis mimicking malignancy in fire eater's lung
No full text28th International Congress of the European-Respiratory-Society (ERS) -- SEP 15-19, 2018 -- Paris, FRANCEInhalation of flammable oily hydrocarbons may cause interstitial pneumonitis by diffusion throughout the bronchial mucosa and alveoli.
A 70 year old male was admitted with progressive dyspnoea, fever, haemoptysis, cough, and sputum for 6 weeks. Physical examination revealed fine crackles on the right side of thorax, and O2 sat: 94%. He had performed fire-eating show 6 weeks ago. Chest x-ray showed irregular opacity on the right lower zone. Thorax computed tomography (CT) was reported a mass (12x11mm) located in the medial and right lower lobe, surrounded the middle lobe bronchus and pulmonary vein, invades to the hilar area, and diaphragm, and surrounded with multiple nodules. Parenteral antibiotic was given since he had leucocytosis, elevated procalsitonin, and sedimentation (111/hr). After 4 weeks, positron emission tomography (PET)-CT was resulted as right hilar lymphadenopathy (19x22mm, SUV: 5), and mass (53x77mm, SUV: 8.7) with satellite nodules and ground glass opacity. Diagnostic bronchoscopy revealed erythema and narrowing of the entrance of medial lobe. Bronchial lavage (BL), and bronchial mucosa biopsy was negative for any pathogens, and malignancy. Transthoracic needle lung biopsy was consistent with “interstitial pneumonitis”. Oral corticosteroid was started as 1mg/kg/day, and gradually tapered in 3 months. Finally, his clinical findings were improved, as well as radiologic abnormalities.
This case illustrates the importance of considering interstitial pneumonitis in fire eaters even some findings are incompliant such as false-posivitiy in PET-CT, and no demonstration of lipid laden macrophages in BL.European Respiratory So
Desensitization in Interferon-beta 1a Allergy: A Case Report
No full textWe report a 41-year-old patient with multiple sclerosis (MS) who was successfully desensitized after she developed non-injection-site urticaria and angioedema due to interferon (IFN)-beta 1a. Although a few cases of urticaria and anaphylaxis have been reported in the literature, to our knowledge this is the first report of a successful desensitization with IFN-beta 1a. Desensitization with IFN-beta 1a allowed us to continue with the administration of interferon-beta, which is a mainstay in treatment for MS. Copyright (C) 2009 S. Karger AG, Base
Does serum leptin levels differ between patients with rhinitis of allergic versus nonallergic aetiology?
No full textBackground Leptin may play a critical role in airway inflammation. However, it has rarely been evaluated in rhinitis with different aetiology. This study aimed to compare the serum leptin levels between allergic rhinitis (AR) and nonallergic rhinitis (NAR). Methods Patients with chronic rhinitis were classified due to skin prick (ALK-Abello/Madrid) and/or serum-specific immunoglobulin E tests (UniCAP 100-Pharmacia), against to aeroallergens if concordant with symptoms. Results A total of 398 patients with a mean age of 29.03 years were recruited and grouped as AR and NAR. Mean serum leptin levels were similar in patients with NAR and AR, as well as in patients with and without asthma, but were significantly higher in females than males in both groups. Also, leptin levels were significantly higher in obese than nonobese patients in AR. In correlation analysis, leptin levels were found to be correlated with female gender, older age, and high body mass index (BMI) in the whole group. Despite the higher total nasal symptom score (TNSS) in patients with AR compared with NAR, there was no association of leptin levels with TNSS, severity and seasonality of symptoms, and allergen sensitization. In logistic regression analysis, younger age and high serum leptin levels were found to be independent predictors for the diagnosis of AR. Conclusions We conclude that female patients with high BMI are more prone to AR probably due to immunological effects of adipose tissue, in addition to hormonal factors. This study showed that leptin measurement has limited value as a sole diagnostic tool to differentiate AR and NAR
Erythema Multiforme-like Dermatitis Due to Isoniazid Hypersensitivity in a Patient With Psoriasis
No full text[Abstract No tAvailable
