Klimek L, Bardenhewer C, Spielhaupter M, Harai C, Becker K, Pfaar O
Zentrum für Rhinologie und Allergologie, An den Quellen 10, 65183, Wiesbaden, Deutschland,
HNO. 2015 May;63(5):364-72. doi: 10.1007/s00106-015-0005-x.
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.
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。
