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Allergic rhinitis with negative skin tests: Does it exist?

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Nonallergic rhinitis (NAR) is a common disorder encountered by the practicing allergist/immunologist. The immunopathology of allergic rhinitis (AR) and NAR share several characteristics. Patients with AR have allergen-specific IgE demonstrable both systemically (e.g., positive skin tests) as well as local IgE produced in the nasal mucosa. A few studies have evaluated patients with NAR using nasal provocation with allergen. Some, but not all, studies have revealed positive allergen challenge in these nonallergic subjects with negative skin tests. This article reviews these studies and highlights the differences in methodology. Further refinements and standardization of nasal provocation techniques may be required before proving that localized IgE-mediated allergy occurs in patients with negative skin tests.
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Keywords: Allergen; IgE; localized; nasal provocation; nonallergic; rhinitis

Document Type: Research Article

Affiliations: Department of Internal Medicine, Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. [email protected]

Publication date: 2009-09-01

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  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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