Assessment of Nasal Immunoglobulin E Level in Atopic and Non-atopic Rhinitis Patients: A Tool for Diagnosis of Local Allergic Rhinitis.

Many cases of AR can be miss-diagnosed due to deficiency in the conventional laboratory tools. Detection of local Ig E immune response and allergy associated genes may aid in diagnosis of these cases. The local immune response and the allergy associated genes of these suspected cases must be evaluated as they may help in their characterization. This study was conducted on 129 patients with chronic rhinitis to determine the frequency of LAR, and analyze the association of IgE receptor (FcεR1β) gene polymorphism with LAR. All participants were subjected to clinical questionnaire, skin prick test, specific IgE measurement in serum and nasal secretions and analysis of FcεR1β gene polymorphism. LAR constituted 24.8 % of total rhinitis cases and 44.4% of non-allergic cases. Cockroach was the main sensitizing agent in local allergic rhinitis in comparison with allergic cases (OR =0.11; 95% CI= 0.04-0.34; P<0.001). In LAR, nasal specific Ig E was significantly lower than that in AR patients (P < 0.001). FcεR1β genotype TT was more frequently expressed in LAR and AR than non-allergic rhinitis (NAR) (P< 0.001). It is concluded that LAR is an emerging allergic condition that could be diagnosed by nasal specific IgE, and that FcεR1β polymorphism is one of the genetic factors associated with AR and LAR.