A Correlation Of Symptomatology With Nasal Smear Eosinophilia In Non-Infectious Chronic Rhinitis Preliminary Report

Abstract

Objective: To correlate subjective and objective clinical features with nasal smear cytology findings in non-infectious chronic rhinitis.

Design: An analysis of prospectively collected data of consecutive patients with non-infectious seasonal and perennial rhinosinusitis seen at a tertiary health institution.

Methodology: Clinical assessments including Visual Analog Scale (VAS) scoring of presenting symptoms of 45 patients suffering from non-infectious chronic rhinosinusitis are measured. Subjects had a medical questionnaire regarding presence and duration of symptoms, family history of atopy or allergy, occupational exposure to allergens, provocative agents, and medication usages. Subjects had detail Ear, Nose, and Throat assessment, and nasal secretions were analyzed for eosinophils counts and statistically correlated with clinical parameter.

Result: A total of 45 patients were recruited. Age range was 13 to 71 years (SD 11.516). 73% (n=33) were females while 27% (n=12) were males. The modal occupation was homemaking (24%, n=11). 38% (n=17) had family history of atopy, while 13% (n=6) had family history of allergy. Symptoms were perennial in 62% (n=28) and seasonal in 38% (n=17). 9% (n=4) of the subjects keep pets at home, while 40% (n=18) grow flowers or trees around the house. All subjects gave a history of identifiable provocative agents. There is positive correlation of itchy nose with total symptom score. There was negative history of occupational exposure to allergens in all subjects. The average subjective symptom score are Sneezing (6.3), Itchy nose (6.1), Nasal obstruction (6.2) and Runny nose (6.7). There is a high positive correlation of sneezing with runny nose (r = 0.51), but poor correlation with nasal obstruction (r = 0.15). There is negative correlation of total individual symptom score with keeping of pets (r = -0.24) or growing of flowers or trees around house (r = -0.039). There is also low correlation of total symptom score with family history of atopy (r = 0.06). There is positive correlation of total symptom score with number of provocative agents identified (r = 0.34). There is low positive correlation of nasal smear eosinophilia with total symptom score (r = 0.030) and itchy nose score (r = 0.038). Nasal smear eosinophilia show negative correlation with sneezing score (r = -0.076).

Conclusion: The best predictors of nasal smear eosinophilia in non-infectious chronic rhinosinusitis are itchy nose score and Individual Total Symptom (ITS) score.


Keywords: Rhinitis, Allergy, Eosinophilia, Symptom Score.

Nigerian Journal of Clinical Practice Vol. 10 (3) 2007 pp. 238-242