PMID- 28727909
OWN - NLM
STAT- MEDLINE
DCOM- 20180515
LR  - 20220408
IS  - 2042-6984 (Electronic)
IS  - 2042-6976 (Linking)
VI  - 7
IP  - 9
DP  - 2017 Sep
TI  - Positive allergen reaction in allergic and nonallergic rhinitis: a systematic 
      review.
PG  - 868-877
LID - 10.1002/alr.21988 [doi]
AB  - BACKGROUND: The diagnosis of allergic rhinitis (AR) is based on cutaneous and 
      serological assessment to determine immunoglobulin E (IgE)-mediated disease. 
      However, discrepancies between these tests and nasal provocation exist. Patients 
      diagnosed as non-allergic rhinitis (NAR) but with positive nasal allergen 
      provocation test (NAPT) may represent a local allergic condition or entopy, still 
      suitable to allergy interventions. The objective of this study was to determine 
      the frequency of nasal reactivity toward allergens among AR and NAR patients, and 
      to describe the diagnostic characteristics of NAPT methodologies. METHODS: EMBASE 
      (1947-) and Medline (1946-) were searched until December 8, 2015. A search 
      strategy was used to identify studies on AR or NAR patients subjected to 
      diagnostic local nasal provocation. All studies providing original NAPT data 
      among the AR or NAR population were included. Meta-analysis of proportion data 
      was presented as a weighted probability % (95% confidence interval [CI]). 
      RESULTS: The search yielded 4504 studies and 46 were included. The probability of 
      nasal allergen reactivity for the AR population was 86.3% (95% CI, 84.4 to 88.1) 
      and in NAR was 24.7% (95% CI, 22.3 to 27.2). Reactivity was high with pollen for 
      both AR 97.1% (95% CI, 94.2 to 99.2) and NAR 47.5% (95% CI, 34.8 to 60.4), and 
      lowest with dust for both AR 79.1% (95% CI, 76.4 to 81.6) and NAR 12.2% (95% CI, 
      9.9 to 14.7). NAPT yielded high positivity when defined by subjective end-points: 
      AR 91.0% (95% CI, 86.6 to 94.8) and NAR 30.2% (95% CI, 22.9 to 37.9); and lower 
      with objective end-points: AR 80.8% (95% CI, 76.8 to 84.5) and NAR 14.1% (95% CI, 
      11.2 to 17.2). CONCLUSION: Local allergen reactivity is demonstrated in 26.5% of 
      patients previously considered non-allergic. Similarly, AR, when defined by 
      skin-prick test (SPT) or serum specific IgE (sIgE), may lead to 13.7% of patients 
      with inaccurate allergen sensitization or non-allergic etiologies.
CI  - (c) 2017 ARS-AAOA, LLC.
FAU - Hamizan, Aneeza W
AU  - Hamizan AW
AD  - Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical 
      Research, University of New South Wales, Sydney, Australia.
AD  - Department of Otolaryngology and Head and Neck Surgery, Universiti Kebangsaan 
      Malaysia, Kuala Lumpur, Malaysia.
FAU - Rimmer, Janet
AU  - Rimmer J
AD  - St Vincent's Clinic, St Vincent's Hospital, Sydney, Australia.
AD  - The Woolcock Institute, Sydney University, Sydney, Australia.
FAU - Alvarado, Raquel
AU  - Alvarado R
AD  - Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical 
      Research, University of New South Wales, Sydney, Australia.
FAU - Sewell, William A
AU  - Sewell WA
AD  - St Vincent's Clinical School, University of New South Wales, Sydney, Australia.
AD  - Garvan Institute, Sydney, Australia.
FAU - Kalish, Larry
AU  - Kalish L
AD  - Sydney Medical School, University of Sydney, Sydney, Australia.
AD  - Department of Otolaryngology-Head and Neck Surgery, Concord General Hospital, 
      University of Sydney, Sydney, Australia.
FAU - Sacks, Raymond
AU  - Sacks R
AD  - Department of Otolaryngology-Head and Neck Surgery, Concord General Hospital, 
      University of Sydney, Sydney, Australia.
AD  - Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
FAU - Harvey, Richard J
AU  - Harvey RJ
AD  - Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical 
      Research, University of New South Wales, Sydney, Australia.
AD  - Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20170720
PL  - United States
TA  - Int Forum Allergy Rhinol
JT  - International forum of allergy & rhinology
JID - 101550261
RN  - 0 (Allergens)
SB  - IM
MH  - Allergens/*immunology
MH  - Humans
MH  - Nasal Provocation Tests
MH  - Rhinitis/*diagnosis/*immunology
OTO - NOTNLM
OT  - aeroallergens
OT  - allergen inhalation challenge
OT  - allergic rhinitis
OT  - entopy
OT  - local allergic rhinitis
OT  - rhinitis
EDAT- 2017/07/21 06:00
MHDA- 2018/05/16 06:00
CRDT- 2017/07/21 06:00
PHST- 2017/03/03 00:00 [received]
PHST- 2017/05/02 00:00 [revised]
PHST- 2017/06/18 00:00 [accepted]
PHST- 2017/07/21 06:00 [pubmed]
PHST- 2018/05/16 06:00 [medline]
PHST- 2017/07/21 06:00 [entrez]
AID - 10.1002/alr.21988 [doi]
PST - ppublish
SO  - Int Forum Allergy Rhinol. 2017 Sep;7(9):868-877. doi: 10.1002/alr.21988. Epub 
      2017 Jul 20.