Eye and nose inflammation assessed by scraping in allergic rhinoconjunctivitis

Published Online: January 26, 2015

Allergic rhinitis affects up to 30% of the general population worldwide and is often associated with conjunctivitis—inflammation of the eye. While the inflammatory aspects of Allergic RhinoConjunctivitis (ARC) are incompletely known, it is well accepted that ARC is associated with local inflammation.
In an article recently published in The Journal of Allergy and Clinical Immunology: In Practice, Gelardi and colleagues evaluated the clinical and cytological characteristics of patients with clinically diagnosed ARC. Clinical aspects were correlated to cytology—done with nasal and conjunctival scrapings, and read with a May-Grunwald staining.

Fifty-one patients with clinically diagnosed ARC underwent a detailed clinical history and diagnostic allergy work-up, as well as nasal and conjunctival scraping for cytological analysis. Patients were subdivided into 3 groups based on cytological phenotype: 1) nasal and conjunctival inflammation; 2) nasal inflammation only; and 3) no mucosal inflammation.

Overall, group 1 patients had higher eye itching scores than patients in groups 2 and 3, and were mostly male (81.8%). Male sex and eye itching significantly correlated with conjunctival inflammation. The chances of a patient exhibiting conjunctival inflammation, at multivariate analysis, increased 13-fold for males and 1.5-fold for each point on the eye itching scale.  A ≥3 cut-off value for eye itching effectively identified patients with conjunctival inflammation.

This study demonstrates that only some clinical characteristics (male gender, and conjunctival itching score) closely correlate with conjunctival inflammation, which is not present in all ARC patients.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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