Atopi Yokluğunda Kronik Rinit Semptomları Olan Hastaların Klinik Özellikleri

Year 2026, Volume: 7 Issue: 1, 120 - 126, 31.01.2026

Gürgün Tuğçe Vural Solak , Kurtuluş Aksu , Alper Kutalmış Türkcan , Yavuzalp Solak

https://doi.org/10.47482/acmr.1737180

Abstract

Arka plan: Kronik rinit burun tıkanıklığı, rinore, hapşırma veya burun/göz kaşıntısı semptomlarının varlığında ortaya çıkar. Ayırıcı tanı koymak önemlidir, çünkü olası tanılara yönelik tedaviler önemli ölçüde farklılık gösterir. Çalışmamızın amacı, kronik rinit semptomları ile başvuran ve atopisi olmayan hastaların klinik özelliklerini belirlemektir.
Yöntemler: Bu prospektif, tanımlayıcı ve kesitsel çalışmada hastaların demografik ve klinik özellikleri analiz edildi. Rinit semptomlarının şiddetini belirlemek için Görsel Analog Skalası (GAS) kullanıldı. Hastalar nazal endoskopik muayene ile değerlendirildi. Nazal endoskopik muayenesi alerjik rinit ile uyumlu olanlar ‘Lokal Alerjik Rinit (LAR)’, diğerleri ise ‘NonAlerjik Rinit (NAR)’ olarak değerlendirildi.
Bulgular: Çalışmamıza dahil edilen 22 hastanın ortanca yaşı 44.5 yıl (dağılım: 18-61) idi. Nazal endoskopi muayenesinde nazal seröz akıntı varlığı LAR grubunda NAR grubuna göre anlamlı olarak daha yüksekti. (p=0.04) Kadın cinsiyet varlığı, eşlik eden alerjik hastalık varlığı, ailede alerjik hastalık varlığı, tetikleyici varlığı, rinore ve burun kaşıntısı GAS skorları LAR grubunda NAR grubuna göre daha yüksekti, ancak istatistiksel olarak anlamlı bir fark bulunmadı.
Sonuç Nazal endoskopik muayenede seröz akıntı, tetikleyicilerle semptomlarda artış, hastada veya ailede alerjik hastalık öyküsü varlığında LAR düşünülmeli ve uygun tedavi başlanmalıdır.

Keywords

lokal alerjik rinit , allerji , atopi , rinit

Clinical Features of Patients with Chronic Rhinitis Symptoms in the Absence of Atopy

Abstract

Background: Chronic rhinitis occurs in the presence of symptoms of nasal congestion, rhinorrhea, sneezing or nasal/ eye itching. It is important to make a differential diagnosis, because the treatments for the possible diagnoses differ considerably. The aim of our study was to determine the clinical characteristics of patients presenting with chronic rhinitis symptoms and without atopy.
Methods: In this prospective, descriptive and cross-sectional study, demographic and clinical characteristics of patients were analysed. Visual Analogue Scale was used to determine the severity of rhinitis symptoms. These patients were examined for nasal endoscopic examination.
Results: The median age of the 22 patients included in our study was 44.5 years (range: 18-61). The presence of nasal serous discharge on nasal endoscopy examination was significantly higher in the suspected LAR group than in the NAR group. (p=0.04) The presence of female gender, presence of concomitant allergic disease, presence of allergic disease in the family, presence of triggers, rhinorrhea and nasal itching scores according to the visual analogue scale were higher in the suspected LAR group than in the NAR group, but no statistically significant difference was found.
Conclusion: Local allergic rhinitis should be suspected, in cases where serous discharge is observed during nasal endoscopy, symptoms are exacerbated by known triggers, or there is a personal or family history of allergic disease.

Keywords

local allergic rhinitis , allergy , atopy , Rhinitis

Ethical Statement

The study was approved by the Clinical Research Ethic Committee of Ankara Atatürk Sanatoryum Training and Research Hospital (Number: 2012-KAEK-15/2585, Acceptance Date: 26.10.2022)

Supporting Institution

This study has received no funding, granting or sponsorship.

Thanks

None

References

• Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al. The diagnosis and management of rhinitis: an updated practice parameter [published correction appears in J Allergy Clin Immunol. 2008 Dec;122(6):1237]. J Allergy Clin Immunol. 2008;122(2 Suppl):S1-S84.
• Hellings PW, Klimek L, Cingi C, Agache I, Akdis C, Bachert C et al. Non-allergic rhinitis: Position paper of the European Academy of Allergy and Clinical Immunology. Allergy. 2017;72(11):1657-1665.
• Rondón C, Campo P, Togias A, Fokkens WJ, Durham SR, Poweet DG ET al. Local allergic rhinitis: concept, pathophysiology, and management. J Allergy Clin Immunol. 2012;129(6):1460-1467.
• Dykewicz MS, Wallace DV, Amrol DJ, Baroody FM, Bernstein JA, Craig TJ et al. Rhinitis 2020: A practice parameter update. J Allergy Clin Immunol. 2020;146(4):721-767.
• Rondón C, Romero JJ, López S, Antúnez C, Martín-Casañez E, Torres MJ et al. Local IgE production and positive nasal provocation test in patients with persistent nonallergic rhinitis. J Allergy Clin Immunol. 2007;119(4):899-905.
• Rondón C, Doña I, López S, Campo P, Romero JJ, Torres MJ et al. Seasonal idiopathic rhinitis with local inflammatory response and specific IgE in absence of systemic response. Allergy. 2008;63(10):1352-1358.
• Gómez E, Campo P, Rondón C, Barrionuevo E, Blanca-López, Torres MJ et al. Role of the basophil activation test in the diagnosis of local allergic rhinitis. J Allergy Clin Immunol. 2013;132(4):975-6.e65.
• Rondón C, Campo P, Galindo L, Blanca-López N, Cassinello MS, Rodriguez-Bada JL et al. Prevalence and clinical relevance of local allergic rhinitis. Allergy. 2012;67(10):1282-1288.
• Meltzer EO, Blaiss MS, Naclerio RM, Stoloff SW, Derebery MJ, Nelsonet HS et al. Burden of allergic rhinitis: allergies in America, Latin America, and Asia-Pacific adult surveys. Allergy Asthma Proc. 2012;33 Suppl 1:S113-S141.
• Jáuregui I, Mullol J, Dávila I, Ferrer M, Bartra J, Cuvilloet AD et al. Allergic rhinitis and school performance. J Investig Allergol Clin Immunol. 2009;19 Suppl 1:32-39
• Bousquet J, Heinzerling L, Bachert C, Papadopoulos NG, Bousquet PJ, Burney PG et al. Practical guide to skin prick tests in allergy to aeroallergens. Allergy. 2012;67(1):18-24.
• Heinzerling L, Mari A, Bergmann KC, Bresciani M, Burbach G, Darsow U et al. The skin prick test - European standards. Clin Transl Allergy. 2013;3(1):3. Published 2013 Feb 1.
• Carney AS, Powe DG, Huskisson RS, Jones NS. Atypical nasal challenges in patients with idiopathic rhinitis: more evidence for the existence of allergy in the absence of atopy?. Clin Exp Allergy. 2002;32(10):1436-1440.
• Rondón C, Fernández J, López S, Campo P, Doña I, Torres MJ,et al. Nasal inflammatory mediators and specific IgE production after nasal challenge with grass pollen in local allergic rhinitis. J Allergy Clin Immunol. 2009;124(5):1005-11.e1.
• López S, Rondón C, Torres MJ, Campo P, Canto G, Fernandez R et al. Immediate and dual response to nasal challenge with Dermatophagoides pteronyssinus in local allergic rhinitis. Clin Exp Allergy. 2010;40(7):1007-1014.
• Rondon C, Campo P, Eguiluz-Gracia I, Plaza C, Bogas G, Galindo P et al. Local allergic rhinitis is an independent rhinitis phenotype: The results of a 10-year follow-up study. Allergy. 2018;73(2):470-478.
• Krajewska-Wojtys A, Jarzab J, Zawadzińska K, Pyrkosz K, Bozek A. Local Allergic Rhinitis in Adult Patients with Chronic Nasal Symptoms. Int Arch Allergy Immunol. 2017;173(3):165-170.
• Bozek A, Ignasiak B, Kasperska-Zajac A, Scierski W, Grzanka A, Jarzab J. Local allergic rhinitis in elderly patients. Ann Allergy Asthma Immunol. 2015;114(3):199-202.
• Rondón C, Blanca-López N, Aranda A, Herrera R, Rodriguez-Bada JL, Canto G et al. Local allergic rhinitis: allergen tolerance and immunologic changes after preseasonal immunotherapy with grass pollen. J Allergy Clin Immunol. 2011;127(4):1069-1071.
• Rondón C, Campo P, Salas M, Aranda A, Molina A, González M et al. Efficacy and safety of D. pteronyssinus immunotherapy in local allergic rhinitis: a double-blind placebo-controlled clinical trial. Allergy. 2016;71(7):1057-1061.