Non allergic rhinitis: demography of eosinophils in nasal smear, blood total eosinophil counts and IgE levels

Abstract

Seventy-eight consecutive patients with non allergic rhinitis (negative allergy skin tests) were evaluated and classified as to possible causes using strict criteria. Sixty-one percent had vasomotor rhinitis (VMR), 33% had non allergic rhinitis with eosinophilia syndrome (NARES), 16% had sinusitis, 12% had a possible hidden allergy (elevated IgE), 4% had blood eosinophilic non allergic rhinitis (BENAR) and 2% had hypothyroidism. Some overlapping of diagnosis was present. Five per cent or greater eosinophils in the nasal smear appeared to be enough to consider the diagnosis of NARES. Sinusitis tended to be more significant in the NARES group compared to VMR. BENARS may be a new syndrome. It differs from NARES in that BENARS has markedly elevated blood eosinophilia and possibly no associated sinusitis. It is similar to NARES in that it has negative allergy skin test, normal serum IgE, and eosinophils in nasal secretions. Other causes of eosinophilia were excluded in our NARES and BENARS groups.