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[对链格孢的局部变应性鼻炎:仅在鼻黏膜中产生局部IgE的证据]

[Local allergic rhinitis to Alternaria alternata : Evidence for local IgE production exclusively in the nasal mucosa].

作者信息

Klimek L, Bardenhewer C, Spielhaupter M, Harai C, Becker K, Pfaar O

机构信息

Zentrum für Rhinologie und Allergologie, An den Quellen 10, 65183, Wiesbaden, Deutschland,

出版信息

HNO. 2015 May;63(5):364-72. doi: 10.1007/s00106-015-0005-x.


DOI:10.1007/s00106-015-0005-x
PMID:25929891
Abstract

In a subgroup of patients with symptoms of allergic rhinitis (AR), no systemic sensitization can be detected in skin tests or serum. These patients are considered to be afflicted with so-called "local allergic rhinitis" (LAR) with IgE-production exclusively at the site of the nasal mucosa. Patients without any positive allergy test results but seasonal (intermittent) or perennial (persistent) allergic symptoms were often misdiagnosed as having "non-allergic rhinitis" (NAR) in the past.However, there is evidence for a specific IgE-production in the nasal mucosa in these patients without systemic sensitization. The diagnosis of LAR is confirmed by clinical symptoms, the detection of specific IgE production in the nasal mucosa and/or nasal provocation tests.We report on two cases of LAR to Alternaria alternata with symptoms of persistent allergic rhinitis that have been diagnosed by positive allergenspecific nasal challenge tests and specific IgE determinations in nasal secretions.According to an actual literature research, this is the second report published on LAR caused by Alternaria alternata.

摘要

在一组有过敏性鼻炎(AR)症状的患者中,皮肤试验或血清检测均未发现全身致敏情况。这些患者被认为患有所谓的“局部过敏性鼻炎”(LAR),其IgE仅在鼻黏膜部位产生。过去,那些没有任何阳性过敏试验结果但有季节性(间歇性)或常年性(持续性)过敏症状的患者,常常被误诊为患有“非过敏性鼻炎”(NAR)。然而,有证据表明,这些没有全身致敏的患者鼻黏膜中存在特异性IgE产生。LAR的诊断通过临床症状、鼻黏膜中特异性IgE产生的检测和/或鼻激发试验来证实。我们报告了两例由链格孢引起的LAR病例,患者有持续性过敏性鼻炎症状,通过阳性变应原特异性鼻激发试验和鼻分泌物中特异性IgE测定得以确诊。根据实际文献研究,这是关于链格孢引起的LAR的第二篇报道。

相似文献

[1]
[Local allergic rhinitis to Alternaria alternata : Evidence for local IgE production exclusively in the nasal mucosa].

HNO. 2015-5

[2]
Local Allergic Rhinitis in Adult Patients with Chronic Nasal Symptoms.

Int Arch Allergy Immunol. 2017

[3]
Local allergic rhinitis in elderly patients.

Ann Allergy Asthma Immunol. 2015-3

[4]
Detection of local allergic rhinitis in children with chronic, difficult-to-treat, non-allergic rhinitis using multiple nasal provocation tests.

Pediatr Allergy Immunol. 2019-2-26

[5]
[Local (exclusive) IgE production in the nasal mucosa. Evidence for local allergic rhinitis].

HNO. 2013-3

[6]
The use of specific immunoglobulin E in nasal secretions for the diagnosis of allergic rhinitis.

Laryngoscope. 2018-9

[7]
Local allergic rhinitis: A critical reappraisal from a paediatric perspective.

Pediatr Allergy Immunol. 2016-9

[8]
[Increased eosinophils in nasal exudation after allergic rhinitis nasal provocation are positively correlated with serum level of specific IgE].

Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi. 2017-1

[9]
Localized immunoglobulin E expression in allergic rhinitis and nasal polyposis.

Curr Opin Otolaryngol Head Neck Surg. 2009-6

[10]
Local IgE in non-allergic rhinitis.

Clin Exp Allergy. 2015-5

引用本文的文献

[1]
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Stud Mycol. 2024-7

[2]
Local Respiratory Allergy: From Rhinitis Phenotype to Disease Spectrum.

Front Immunol. 2021

[3]
infection causing rhinosinusitis and orbital involvement in an immunocompetent patient.

New Microbes New Infect. 2019-5-16

[4]
International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis.

Int Forum Allergy Rhinol. 2018-2

[5]
Local allergic rhinitis: evolution of concepts.

Clin Transl Allergy. 2017-11-2

本文引用的文献

[1]
[Local (exclusive) IgE production in the nasal mucosa. Evidence for local allergic rhinitis].

HNO. 2013-3

[2]
Local allergic rhinitis: concept, pathophysiology, and management.

J Allergy Clin Immunol. 2012-4-18

[3]
A role for measurement of nasal IgE antibodies in diagnosis of Alternaria-induced rhinitis in children.

Allergol Immunopathol (Madr). 2012

[4]
[Allergic rhinitis. Immunological and neurogenic mechanisms].

HNO. 2011-12

[5]
Local allergic rhinitis: allergen tolerance and immunologic changes after preseasonal immunotherapy with grass pollen.

J Allergy Clin Immunol. 2011-4

[6]
Local allergic rhinitis: concept, clinical manifestations, and diagnostic approach.

J Investig Allergol Clin Immunol. 2010

[7]
Local allergic rhinitis: a new entity, characterization and further studies.

Curr Opin Allergy Clin Immunol. 2010-2

[8]
Nasal inflammatory mediators and specific IgE production after nasal challenge with grass pollen in local allergic rhinitis.

J Allergy Clin Immunol. 2009-11

[9]
Evolution of patients with nonallergic rhinitis supports conversion to allergic rhinitis.

J Allergy Clin Immunol. 2009-5

[10]
Seasonal idiopathic rhinitis with local inflammatory response and specific IgE in absence of systemic response.

Allergy. 2008-10

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