Arslan H, Gunduz O, Basaran M, Kocaturk S
B-ENT. 2016;12(4):315-322.
Corticosteroid hypersensitivity in allergic rhinitis.
intranasal corticosteroid (IC) is the most effective treatment method in allergic rhinitis patients who are unresponsive to antihistamines. The literature reports an approximate 20% treatment failure for instances where IC is used for the treatment allergic rhinitis. Hypersensitivity reaction to corticosteroids may be one of the causes of this treatment failure.
to discover the incidence and confounding factors of corticosteroid hypersensitivity in patients with allergic rhinitis.
after 31 patients were excluded, 150 consecutive patients who were prospectively evaluated in our outpatient clinics with the diagnosis of allergic rhinitis and 50 age- and sex- matched healthy volunteers were included in this study. To diagnose allergic rhinitis, the symptoms of patients and a skin prick test were used. A skin patch test was used to determine corticosteroid hypersensitivity. Total IgE values and total eosinophil count were obtained for all patients. Total symptom scores were calculated for the severity of symptoms and to determine the response to therapy using intranasal corticosteroids.
the incidence of corticosteroid hypersensitivity determined via the skin patch test was 14.0% (21 out of 150 patients). A difference was observed for patch test positivity results between the study and control groups (14% vs. 0%, respectively). Serum IgE levels and total eosinophil count were higher among patients who had corticosteroid hypersensitivity (p:0.005 and p:0.004, respectively). Patients unresponsive to intranasal corticosteroids had a higher incidence of corticosteroid hypersensitivity (71.4% vs. 4.4%, p<0.00 1).
our study is the largest to date investigating CH in patients with allergic rhinitis and patients with allergic rhinitis have been found to have a high incidence (14%) of corticosteroid hypersensitivity, which may affect the response of patients to intranasal corticosteroid treatment.
变应性鼻炎中的皮质类固醇超敏反应
鼻内皮质类固醇（IC）是对抗组胺药无反应的变应性鼻炎患者最有效的治疗方法。文献报道，IC用于治疗变应性鼻炎时，约有20%的治疗失败率。对皮质类固醇的超敏反应可能是治疗失败的原因之一。
探讨变应性鼻炎患者中皮质类固醇超敏反应的发生率及相关混杂因素。
排除31例患者后，本研究纳入了150例在我们门诊接受前瞻性评估且诊断为变应性鼻炎的连续患者以及50例年龄和性别匹配的健康志愿者。采用患者症状和皮肤点刺试验诊断变应性鼻炎。采用皮肤斑贴试验确定皮质类固醇超敏反应。获取所有患者的总IgE值和嗜酸性粒细胞总数。计算总症状评分以评估症状严重程度并确定鼻内皮质类固醇治疗的反应。
通过皮肤斑贴试验确定的皮质类固醇超敏反应发生率为14.0%（150例患者中的21例）。研究组和对照组的斑贴试验阳性结果存在差异（分别为14%和0%）。皮质类固醇超敏反应患者的血清IgE水平和嗜酸性粒细胞总数较高（分别为p = 0.005和p = 0.004）。对鼻内皮质类固醇无反应的患者中皮质类固醇超敏反应的发生率更高（71.4%对4.4%，p<0.001）。
我们的研究是迄今为止调查变应性鼻炎患者皮质类固醇超敏反应的最大规模研究，发现变应性鼻炎患者中皮质类固醇超敏反应的发生率较高（14%），这可能会影响患者对鼻内皮质类固醇治疗的反应。
