Prevalence and clinical relevance of local allergic rhinitis

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Evidence demonstrates the existence of local allergic rhinitis (<jats:styled-content style="fixed-case">LAR</jats:styled-content>) in nonatopic patients, although its prevalence in the rhinitis population remains unknown. The aim, therefore, of this study was to evaluate the prevalence, clinical characteristics, and severity of <jats:styled-content style="fixed-case">LAR</jats:styled-content> in a <jats:styled-content style="fixed-case">S</jats:styled-content>panish rhinitis population, compared with patients having classical allergic rhinitis (<jats:styled-content style="fixed-case">AR</jats:styled-content>) with systemic atopy or nonallergic rhinitis (<jats:styled-content style="fixed-case">NAR</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A group of 452 adult rhinitis patients were randomly selected from a total of 3860 who attended our allergy service over 1 year. A clinical questionnaire, skin prick test (<jats:styled-content style="fixed-case">SPT</jats:styled-content>), spirometry, and serum total and specific IgE (<jats:styled-content style="fixed-case">sIgE</jats:styled-content>) were evaluated. A nasal allergen provocation test with multiple aeroallergens (NAPT‐M), including <jats:italic><jats:styled-content style="fixed-case">D</jats:styled-content>ermatophagoides pteronyssinus</jats:italic>, pollens, <jats:italic>alternaria</jats:italic>, and dog epithelia, was performed in patients with negative SPT and serum <jats:styled-content style="fixed-case">sIgE</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 428 patients completed the study; 24 were excluded because of nasal hyper‐reactivity. <jats:styled-content style="fixed-case">LAR</jats:styled-content> was diagnosed in 25.7%, <jats:styled-content style="fixed-case">AR</jats:styled-content> in 63.1%, and <jats:styled-content style="fixed-case">NAR</jats:styled-content> in 11.2%. The <jats:styled-content style="fixed-case">LAR</jats:styled-content> and <jats:styled-content style="fixed-case">AR</jats:styled-content> patients had a similar clinical profile: a nonsmoking woman with severe, persistent perennial rhinitis frequently associated with conjunctivitis and asthma. More than 36% of <jats:styled-content style="fixed-case">LAR</jats:styled-content> patients reported rhinitis onset in childhood. <jats:styled-content style="fixed-case">NAPT</jats:styled-content>‐M detected aeroallergen polysensitization in 37.3% of the <jats:styled-content style="fixed-case">LAR</jats:styled-content> patients. <jats:italic><jats:styled-content style="fixed-case">D</jats:styled-content>ermatophagoides pteronyssinus</jats:italic> was the main sensitizing aeroallergen in <jats:styled-content style="fixed-case">LAR</jats:styled-content> and <jats:styled-content style="fixed-case">AR</jats:styled-content> (60% <jats:italic>vs</jats:italic> 54%, <jats:italic>P </jats:italic>><jats:italic> </jats:italic>0.05).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Local allergic rhinitis is a prevalent entity in patients evaluated with rhinitis. Persistent and severe symptoms associated with conjunctivitis and/or asthma and polysensitization were likely to be detected in <jats:styled-content style="fixed-case">LAR</jats:styled-content> and <jats:styled-content style="fixed-case">AR</jats:styled-content>.</jats:p></jats:sec>