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[Non-allergic rhinitis with eosinophilic syndrome. Case report]
Rodrigo Collado-Chagoya1, Javier Hernández-Romero, Gumaro Alejandro Eliosa-Alvarado
1Secretaría de Salud, Hospital General de México, Servicio de Inmunología Clínica y Alergia, Ciudad de México, México. rodnova87@hotmail.com.
Revista Alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)
|September 4, 2018
Summary
Non-allergic rhinitis with eosinophilic syndrome (NARES) is an underdiagnosed condition characterized by nasal inflammation and eosinophils without allergies. High diagnostic suspicion is crucial for accurate identification and management.
Area of Science:
- Allergy and Immunology
- Otorhinolaryngology
Background:
- Rhinitis, a common allergy consultation cause, involves chronic nasal mucosa inflammation.
- Non-allergic rhinitis with eosinophilic syndrome (NARES) features >20% eosinophils in nasal cytology without allergy.
- NARES often co-occurs with sinonasal issues and increases obstructive sleep apnea risk.
Observation:
- A 7-year-old girl presented with seasonal rhinorrhea, nasal obstruction, itching, and sneezing.
- She exhibited significant blood and nasal eosinophilia (800 eosinophils/μL and 30%, respectively).
- Allergy tests, including skin and nasal challenge tests, were negative, confirming NARES.
Findings:
- NARES is frequently underdiagnosed due to limited in vivo nasal testing.
- Lack of specific local in vivo tests (nasal specific IgE) contributes to underestimation.
- Accurate NARES diagnosis requires high clinical suspicion by specialists.
Implications:
- Increased awareness and diagnostic vigilance for NARES are essential.
- Improved diagnostic tools for NARES could enhance patient care.
- Understanding NARES's association with other sinonasal conditions is vital for comprehensive management.
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