A clinical study of inhalant allergens in patients with allergic rhinitis
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20171197Keywords:
Allergy, Allergens, CCD [Carbohydrate Cross-reactive Determinants], Allergic RhinitisAbstract
Background: The basis of diagnosis of allergy requires a good history and examination, however, the diagnosis cannot be confirmed on the basis of symptoms alone, because both allergic and non-allergic conditions can present with similar symptoms. Hence, allergy testing in the form of specific IgE (sIgE) measurement is an important aid in demonstrating both the presence and severity of such an allergy. The present study was undertaken to find out the common environmental allergens prevailing in Raichur causing allergic rhinitis, using carbohydrate cross reactive determinants (CCD), an in vitro test with high degree of sensitivity.
Methods: The present prospective study was conducted among 30 patients with allergic rhinitis. A detailed general andENT examination were done, X-ray ofPNS, CT scan ofPNS, diagnostic nasal endoscopy and nasal smear examination for eosinophils, absolute eosinophil count and serum IgE levels using Euroimmun system of in vitro assay of specific IgE antibodies.
Results: Allergy to dust mite, D. faranie, corn, carnation flower, sunflower, sheep wool and straw dust were the most frequent allergens causing allergic symptoms among patients in Raichur area. Total serum IgE was elevated in all the patients, 60% were allergic to dust mite as found by anti CCD specific IgE.
Conclusions: Antibodies to dust mite D. faranie, rye, T. mothy grass was the commonest finding. Identification of inhalant allergens is an important factor in prevention and treatment of allergic rhinitis.
References
Al-Mughales JA. Diagnostic Utility of Total IgE in Foods, Inhalant, and Multiple Allergies in Saudi Arabia. J Immunol Res. 2016;2016:1-8.
Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens Ahlstedt S, Murray CS. In vitro diagnosis of allergy: how to interpret IgE antibody results in clinical practice. Prim Care Respir J. 2006;15(4):228-36.
Hannuksela A, Vaananen A. Predisposing factors for malocclusion in 7-year-old children with special reference to atopic diseases. Am J Orthod Dentofacial Orthop. 1987;92:299-303.
Ahlstedt S, Murray CS. In vitro diagnosis of allergy: how to interpret IgE antibody results in clinical practice. Prim Care Respir J. 2006;15(4):228-36.
Badran HS, Hussein A, Salah M, Lotfi WT. Identification and Prevalence of Allergic, Nonallergic, and Local Allergic Rhinitis Patients in Western Area, Saudi Arabia. Ann Otol, Rhinol Laryngol. 2016;125(8):634-43.
Adeli M. Allergy and Immunology Awareness Program (AIAP) Allergic Rhinitis Guide. Available at: https://www.hamad.qa/EN/your%20health/
allergy-and-immunology/publications/Documents/
Allergic-Rhinitis-English.pdf. Accessed on 3 January 2017.
Somani VK. A study of allergen-specific IgE antibodies in Indian patients of atopic dermatitis. Indian J Dermatol Venereol Leprol. 2008;74:100-4.
Dullaers M, De Bruyne R, Ramadani F, Gould HJ, Gevaert P, Lambrecht BN. The who, where, and when of IgE in allergic airway disease. J Allergy Clin Immunol. 2012;129(3):635-45.
Guerra S, Sherrill DL, Martinez FD, Barbee RA. Rhinitis as an independent risk factor for adult-onset asthma. J Allergy Clin Immunol. 2002;109:419-25.
Shaaban R, Zureik M, Soussan D, et al. Rhinitis and onset of asthma: a longitudinal population based study. Lancet. 2008;372:1049-57.
Wheatley LM, Togias A. Allergic Rhinitis. N Engl J Med. 2015; 372:456-463.
Mari A, Iacovacci P, Afferni C, Barletta B, Tinghino R, Di Felice G, Pini C. Specific IgE to cross-reactive carbohydrate determinants strongly affect the in vitro diagnosis of allergic diseases. J Allergy Clin Immunol. 1999;103(6):1005-11.
Chung D, Park KT, Yarlagadda B, Davis EM, Platt M. The significance of serum total immunoglobulin E for in vitro diagnosis of allergic rhinitis. Int Forum Allergy Rhinol. 2014;4(1):56-60.
Naspitz CK, Sole D, Jacob CA, Sarinho E, Soares FJP, Dantas V, et al. Sensitization to inhalant and food allergens in Brazilian and atopic children, by in vitro determination of total and specific IgE: Allergy Project (PROAL). J Pediatr (Rio J). 2004;80(3):203-10.
Lopez N, de Barros-Mazon S, Vilela MM, Condino Neto A, Ribeiro JD. Are immunoglobulin E levels associated with early wheezing? A prospective study in Brazilian infants. Eur Respir J. 2002;20:640-5.
Lang DM, Nicklas RA, Oppenheimer J, Portnoy JM, Randolph JJ, Schuller D, Spector SL, Tilles SA. The diagnosis and management of rhinitis: An updated practice parameter. J Allergy Clin Immunol. 2008;122:1-84
Chad Z. Allergies in children. Paed Child Health. 2001;6(8):555-66
Mims JW, Veling MC. Inhalant allergies in children. Otolaryngol Clin North Am. 2011;44(3):797-814.
Horwood LJ, Fergusson DM, Shannon FT. Social and familial factors in the development of early childhood asthma. Pediatrics. 1985;75:859–68.
Williams P, Sewell WAC, Bunn C, Pumphrey R, Read G, Jolles S. Clinical Immunology Review Series: An approach to the use of the immunology laboratory in the diagnosis of clinical allergy. Clin Exp Immunol. 2008;153(1):10-8.
Duran-Tauleria E, Vignati G, Guedan MJA, Petersson CJ. The utility of specific immunoglobulin E measurements in primary care. Allergy. 2004;59(78):35–41.
Kumar S, Kumar R. Efficacy and safety of tacrolimus eye ointment in refractory vernal keratoconjunctivitis in eastern India. International J Contemporary Med Res. 2016;3(11):3289-91.