Collado-Chagoya Rodrigo, Hernández-Romero Javier, Eliosa-Alvarado Gumaro Alejandro, García-González Ana Carmen, Campos-Gutiérrez Rosa Isela, Velasco-Medina Andrea Aída, Velázquez-Sámano Guillermo
Secretaría de Salud, Hospital General de México, Servicio de Inmunología Clínica y Alergia, Ciudad de México, México.
Rev Alerg Mex. 2018 Jul-Sep;65(3):310-315. doi: 10.29262/ram.v65i3.336.
Rhinitis is the leading cause for consultation in the allergy department. It consists in chronic inflammation of the nasal mucosa. Non-allergic rhinitis with eosinophilic syndrome is characterized by chronic inflammation of the nasal mucosa (> 20% of eosinophils in nasal cytology) in the absence of demonstrable allergy (negative in vivo and in vitro tests); often it is accompanied by other sinonasal conditions (nasal polyposis, chronic rhinosinusitis), and it constitutes a risk factor for the development of obstructive sleep apnea.
Seven-year old girl with rhinorrhea, nasal obstruction, nasopalatine itching, and severe sneezing that limited sleep and school activities. This condition had a seasonal pattern, with important blood (800 eosinophils/μL) and nasal (30%) eosinophilia and absence of demonstrable allergy (negative skin tests, negative specific nasal challenge tests); the non-allergic rhinitis with eosinophilic syndrome diagnosis was verified.
Non-allergic rhinitis with eosinophilic syndrome is considered to be a highly underdiagnosed disease owing to the lack of in vivo nasal tests' performance; to this underestimation, incorrect nasal etiology and lack of local in vivo tests (nasal specific IgE) are added, which warrants a high degree of diagnostic suspicion by the specialist physician.
鼻炎是过敏科就诊的主要原因。它表现为鼻黏膜的慢性炎症。嗜酸性粒细胞综合征性非过敏性鼻炎的特征是鼻黏膜慢性炎症（鼻细胞学检查中嗜酸性粒细胞>20%），且无明显过敏表现（体内和体外试验均为阴性）；通常伴有其他鼻窦疾病（鼻息肉、慢性鼻-鼻窦炎），并且是阻塞性睡眠呼吸暂停发生的危险因素。
一名7岁女孩，有流涕、鼻塞、鼻腭部瘙痒和严重打喷嚏症状，这些症状限制了睡眠和学校活动。这种情况呈季节性发作，血液中嗜酸性粒细胞显著增多（800个/μL），鼻腔中嗜酸性粒细胞比例为30%，且无明显过敏表现（皮肤试验阴性，特异性鼻激发试验阴性）；嗜酸性粒细胞综合征性非过敏性鼻炎的诊断得到证实。
由于缺乏体内鼻腔试验，嗜酸性粒细胞综合征性非过敏性鼻炎被认为是一种诊断严重不足的疾病；除了这种低估之外，鼻腔病因诊断错误以及缺乏局部体内试验（鼻特异性IgE）也存在，这就需要专科医生高度怀疑其诊断。
