Prevalence and clinical relevance of local allergic rhinitis

Background Evidence demonstrates the existence of local allergic rhinitis ( LAR ) in nonatopic patients, although its prevalence in the rhinitis population remains unknown. The aim, therefore, of this study was to evaluate the prevalence, clinical characteristics, and severity of LAR in a S panish rhinitis population, compared with patients having classical allergic rhinitis ( AR ) with systemic atopy or nonallergic rhinitis ( NAR ). Methods A group of 452 adult rhinitis patients were randomly selected from a total of 3860 who attended our allergy service over 1 year. A clinical questionnaire, skin prick test ( SPT ), spirometry, and serum total and specific IgE ( sIgE ) were evaluated. A nasal allergen provocation test with multiple aeroallergens (NAPT‐M), including D ermatophagoides pteronyssinus , pollens, alternaria , and dog epithelia, was performed in patients with negative SPT and serum sIgE . Results A total of 428 patients completed the study; 24 were excluded because of nasal hyper‐reactivity. LAR was diagnosed in 25.7%, AR in 63.1%, and NAR in 11.2%. The LAR and AR patients had a similar clinical profile: a nonsmoking woman with severe, persistent perennial rhinitis frequently associated with conjunctivitis and asthma. More than 36% of LAR patients reported rhinitis onset in childhood. NAPT ‐M detected aeroallergen polysensitization in 37.3% of the LAR patients. D ermatophagoides pteronyssinus was the main sensitizing aeroallergen in LAR and AR (60% vs 54%, P  >   0.05). Conclusions Local allergic rhinitis is a prevalent entity in patients evaluated with rhinitis. Persistent and severe symptoms associated with conjunctivitis and/or asthma and polysensitization were likely to be detected in LAR and AR .