Non-allergic rhinitis with eosinophilic syndrome. Case report

• Main Authors: Rodrigo Collado-Chagoya, Javier Hernández-Romero, Gumaro Alejandro Eliosa-Alvarado, Ana del Carmen García-González, Rosa Isela Campos-Gutiérrez, Andrea Aída Velasco-Medina, Guillermo Velázquez-Sámano
• Format: Article
• Language: Spanish
• Published: Colegio Mexicano de Inmunología Clínica y Alergia, A.C. 2018-07-01
• Series: Revista Alergia México
• Subjects: rinitis no alérgica con síndrome eosinofílico; eosinofilia; citología nasal
• Online Access: http://revistaalergia.mx/ojs/index.php/ram/article/view/336
• ISSN: 0002-5151; 2448-9190

Background: Rhinitis is the leading cause for consultation in the allergy department. It consists in chronic inflammation of the nasal mucosa. Non-allergic rhinitis with eosinophilic syndrome is characterized by chronic inflammation of the nasal mucosa (> 20% of eosinophils in nasal cytology) in the absence of demonstrable allergy (negative in vivo and in vitro tests); often it is accompanied by other sinonasal conditions (nasal polyposis, chronic rhinosinusitis), and it constitutes a risk factor for the development of obstructive sleep apnea. Clinical case: Seven-year old girl with rhinorrhea, nasal obstruction, nasopalatine itching, and severe sneezing that limited sleep and school activities. This condition had a seasonal pattern, with important blood (800 eosinophils/μL) and nasal (30%) eosinophilia and absence of demonstrable allergy (negative skin tests, negative specific nasal challenge tests); the non-allergic rhinitis with eosinophilic syndrome diagnosis was verified. Conclusions: Non-allergic rhinitis with eosinophilic syndrome is considered to be a highly underdiagnosed disease owing to the lack of in vivo nasal tests’ performance; to this underestimation, incorrect nasal etiology and lack of local in vivo tests (nasal specific IgE) are added, which warrants a high degree of diagnostic suspicion by the specialist physician.