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Fulltext Recent trends in the diagnosis and management of allergic rhinitis

Elango S

Med J Malaysia, 2005 Dec;60(5):672-6; quiz 677.
PMID: 16515128

Allergic rhinitis is a global health issue and its prevalence is increasing. Allergic rhinitis and asthma coexist in many patients. Allergic rhinitis is an Ig E mediated reaction. Prostaglandins and Leukotriens do not play a significant role in the pathogenesis of allergic rhinitis. Skin prick test and Enzyme linked immunosorbent assays (ELISA) are useful as diagnostic tests. The three major modalities of treatment for allergic rhinitis are allergen avoidance, pharmacotherapy and immunotherapy.

Matched MeSH terms: Rhinitis, Allergic, Perennial/diagnosis*
Fulltext Allergic rhinitis--analysis of skin testing in 774 patients

Gurbachan I, Idruss H

Med J Malaysia, 1983 Jun;38(2):121-5.
PMID: 6621441

This study shows that out of 774 patients tested, the house dust mite (Dermatophagoides pteronyssinus) provoked the maximum response (51.81%) the house dust was second (42.81%), and shrimp was third (23.92%). The moderate allergenic extracts were cat fur (12.79%), dog fur (10.72%), cockroach (8.47%) egg white (7.56%) and orris powder (6.30%). Among the low allergenic extracts were Aspergillus fumigatus (5.38%), Staphyloccus aureaus (3.53%) and chicken feathers (3.18%). The authors are of the opinion that the skin sensitivity test is an important diagnostic tool in allergic rhinitis and since this is a preliminary study any short listing of allergens to be used is not recommended yet. Skin sensitivity tests is a useful tool for differentiating allergic rhinitis from vasomotor rhinitis. Estimation of allergen specific IgE concentration in the serum will not offer any major advantages over the intradermal skin test in determining the clinical significance of house dust mite allergy. 21 The development of local materials for skin testing may enhance the usefulness of these investigations.

Matched MeSH terms: Rhinitis, Allergic, Perennial/diagnosis*
Fulltext A study on perennial rhinitis in Kelantan

Elango S, Purohit GN, Gan SC, Manap Z, Raza H

Med J Malaysia, 1989 Sep;44(3):231-5.
PMID: 2696872

Ninety five patients with perennial rhinitis were examined clinically and various investigations were done in order to find out the common allergens and to assess the value of various tests in perennial rhinitis. In this study group 94% of cases were proven to be cases of allergic rhinitis. Cat fur was found to be the commonest allergen. Grass pollen which is a common allergen in European countries was found in only 18% of cases in the present study. X-ray of the paranasal sinuses as a routine investigation was not found to be of much use in perennial rhinitis. There was significant correlation between results for allergens tested by enzyme immunoassay and skin prick test.

Matched MeSH terms: Rhinitis, Allergic, Perennial/diagnosis
Fulltext Skin prick test reactivity to common airborne pollens and molds in allergic rhinitis patients

Wan Ishlah L, Gendeh BS

Med J Malaysia, 2005 Jun;60(2):194-200.
PMID: 16114160 MyJurnal

Allergic rhinitis is the single most common chronic allergic disease affecting an estimated four million people in Malaysia. House dust mites, grass pollens and fungal spores play has been identified to play a major role in the pathogenesis of allergic rhinitis. However, sensitization to pollen and spores in Malaysia is not well documented. On the basis of the results of an aerobiological survey of the common mold spores and pollens in the Klang Valley, twelve local extracts of molds and two local extracts of grass pollens were prepared by the Institute for Medical Research for this study. The study evaluated the prevalence of skin prick test (SPT) reactivity to the extracts of those airborne molds and pollens in allergic rhinitis patients in the Klang Valley. A total of 85 allergic rhinitis patients were recruited. All molds and grass pollens extracts tested, elicited positive response to SPT. Among the molds extracts, Fusarium was observed to have the highest prevalence of SPT reactivity (23.5%), followed by Aspergillus flavum (21.2%), Dreselera orysae (18.8%), Alternaria sp (17.6%), Curvularis eragrostidis (17.6%), Penicillium oxa (16.5%), Pestolotriopsis gtuepini (16.5%), Rhizopphus arrhi (16.5%), Aspergilluls nigus (15.3%). Penicillium choy (12.9%), Aspergillus fumigatus (11.8%), and Cladosporium sp (4.7%). In the grass pollen, the SPT reactivity to Ischaemum and Enilia is 14.1% and 5.9% respectively. However, the prevalence of SPT reactivity was not influenced by the age, sex, ethnicity, symptomatology and concurrent allergic condition. We have documented the prevalence of skin prick test reactivity to common molds and grass pollens in the Klang valley, which is comparable to the neighboring countries. Its prevalence in our allergic rhinitis patients suggests that it has a role in pathogenesis of allergic diseases. A larger representative sample involving multi-centric centers in Malaysia should be encouraged in the near future.

Study site: ENT
Department, Pusat Perubatan University Kebangsaan Malaysia
(PPUKM)

Matched MeSH terms: Rhinitis, Allergic, Perennial/diagnosis*
Nasopharyngeal carcinoma and nasal allergy: any correlation?

Prepageran N, Lingham OR, Krishnan G, Jalaludin MA, Raman R

Ear Nose Throat J, 2003 Jun;82(6):438-40.
PMID: 12861869

Although it has been observed that nasal allergy is rarely seen in patients who have nasopharyngeal carcinoma, to our knowledge, no actual study of such a lack of association has been previously reported. To fill this void, we conducted a pilot study to investigate any such inverse relationship. We conducted skin-prick allergen tests on 22 patients with newly diagnosed but not-yet-treated nasopharyngeal carcinoma. Combining these test results with findings on the history and clinical examination, we concluded that only one of the 22 cancer patients (4.5%) had allergic rhinitis. Our study also confirmed the validity of using findings on the history, clinical examination, and skin-prick testing as a reliable means of diagnosing allergic rhinitis.

Matched MeSH terms: Rhinitis, Allergic, Perennial/diagnosis*
Objective assessment of nasal resistance in patients with nasal disease

Suzina AH, Hamzah M, Samsudin AR

J Laryngol Otol, 2003 Aug;117(8):609-13.
PMID: 12956914

Nasal obstruction is a subjective complaint in patients with nasal disease. The ability to quantitate the nasal ventilation dysfunction would be useful for making the appropriate choice of nasal disease management. This cross-sectional study comprised of 200 adult subjects. They underwent assessment of relevant symptoms, nasal examination and investigations before undergoing active anterior rhinomanometry (AAR) assessment. A group of 88 normal subjects and 112 patients with nasal disease were included. The mean total nasal air resistance (NAR) was significantly higher in patients with nasal disease (0.33 Pa/cm(3)/s) as compared to normal subjects (0.24 Pa/cm(3)/s). There was no significant difference in total NAR between patients with symptoms of nasal obstruction and those without the symptoms (p = 0.42). It is concluded that AAR is a sensitive but not a specific tool for the detection of abnormalities in NAR and it failed to relate to the symptom of nasal obstruction.

Matched MeSH terms: Rhinitis, Allergic, Perennial/diagnosis
Specific IgE in the identification of allergens in allergic rhinitis Malaysian patients

Choon-Kook S, Teck-Soong SL

Asian Pac J Allergy Immunol, 1995 Jun;13(1):23-7.
PMID: 7488340

The specific serum IgE levels to 20 allergens were determined by enzyme immunoassay in 90 Malaysian patients with allergic rhinitis. Ninety-two percent of patients had elevated IgE to at least 1 of the allergens. The housedust mites D. pteronyssinus and D. farinae were the major allergens, elevated IgE to either allergen being present in 86% of the patients. Prick skin tests were carried out in some of the patients, housedust mites, cat fur, dog hair and shrimp were the allergens used. Close correspondence was found between IgE and prick skin tests to the mites.

Matched MeSH terms: Rhinitis, Allergic, Perennial/diagnosis
Clinical features of allergic rhinitis and skin prick test analysis based on the ARIA classification: a preliminary study in Malaysia

Asha'ari ZA, Yusof S, Ismail R, Che Hussin CM

Ann Acad Med Singap, 2010 Aug;39(8):619-24.
PMID: 20838703

INTRODUCTION: Allergic rhinitis (AR) is a prevalent disease worldwide but is still underdiagnosed in many parts of Asia. We studied the clinical profiles of AR patients in our community based on the new ARIA classification and investigated the aetiological allergens using a skin prick test.
MATERIALS AND METHODS: In 2008, 142 newly diagnosed patients with AR were seen and underwent skin prick testing with 90 patients completing the study.
RESULTS: Intermittent mild and moderate/severe AR were evident in 10% and 21.1% of the patients, while persistent mild and moderate/severe were seen in 20% and 48.9%, respectively. Rhinitis and asthma co-morbidity occurred in 28.8% with asthma incidence significantly higher in persistent AR (P = 0.002). There was no significant association between AR severity, city living and asthma co-morbidity. Nasal itchiness and sneezing were the main presenting complaints and were more common in intermittent AR (P <0.05). Sleep disturbance was associated with moderate-severe AR (P <0.05). Polypoidal mucosa was associated with asthma co-morbidity (P <0.05). Monosensitivity reaction occurred in 12.2% of patients and was associated with fungi sensitivity (P <0.05). Majority of patients were oligosensitive (52.8%) and polysensitive (34.4%) and were significantly associated with moderate-severe persistent AR (P <0.01). The highest positive skin prick reaction and the largest average wheal diameter were for the house dust mites and cat allergen (P <0.05).
CONCLUSION: Our results reflected the AR profiles in our country, which was comparable with typical profiles of the neighbouring country and other Mediterranean countries with a similar temperate climate.

Matched MeSH terms: Rhinitis, Allergic, Perennial/diagnosis*