Local production of specific IgE antibodies in allergic-rhinitis patients with negative skin tests.

A group of patients with allergic rhinitis had a clinical history strongly suggestive of house-dust-mite (Dermatophagoides pteronyssinus) allergy but negative skin reactions when prick tested with D. pteronyssinus extracts. These patients were proved to be clinically allergic by nasal provocation with this allergen. Although radioallergosorbent tests showed that these patients lacked specific IgE antibodies in their serum, they did have specific antibodies in their nasal secretions. These findings indicate that these patients had allergic rhinitis mediated by the local production of IgE antibodies.