[Non-allergic eosinophilic rhinitis. From clinical diagnosis to pathogenic study].

Non allergic rhinitis with eosinophilia syndrome is not an uncommon diagnosis, since eosinophilia in nasal secretions from 20% up to 90% of total cells, is detected in 15% of rhinitis. Nasal symptoms include sneezing paroxysms, profuse watery rhinorrhea, in adults or in children. All immunological tests are negative. Tomodensitometry may detect evolution towards sinusal polyposis, and bronchial challenges with carbamylcholine may detect bronchial hyper-reactivity. We conclude to the possibility for NARES to be a link between common vasomotor rhinitis and nasal polyposis with asthma and intolerance to aspirin. The diagnosis needs to be firmly established by the study of nasal eosinophilia during a nasal challenge with a perennial allergen (house dust mite). The first has to be unchanged, and the second has to be negative. As eosinophils are potent pro-inflammatory cells endowed with cytotoxicity, precise studies upon the characteristics of eosinophils in the nasal secretions and in the pituitary mucosa of patients with NARES, have to be carried on.