Chronic non-allergic rhinitis with neutrophils is associated with higher acid exposure time: A pH-impedance monitoring study. Issue 4 (April 2020)

• Record Type: Journal Article
• Authors: Mandolesi, Daniele; Schiavon, Patrizia; Ioannou, Alexandros; Mancini, Michela; Cimatti, Maria Chiara; Azzaroli, Francesco; Liverani, Elisa; Pierantoni, Chiara; Pirodda, Antonio; De Giorgio, Roberto; Bazzoli, Franco; Torresan, Francesco
• Is Part Of: Digestive and liver disease. Volume 52:Issue 4(2020)
• Page Start: 414
• Page End: 419
• Publication Date: 2020-04
• Subjects: AET acid exposure time -- AR allergic rhinitis -- ENT Ear, Nose and Throat -- GERD gastroesophageal reflux disease -- HRM high-resolution manometry -- LES lower esophageal sphincter -- NAR non-allergic rhinitis -- NARES non-allergic rhinitis with eosinophils -- NARESMA non-Allergic Rhinitis with Eosinophils and Mast Cells -- NARMA non-allergic rhinitis with mast cells -- NARNE non-allergic rhinitis with neutrophils -- MII-pH multichannel intraluminal impedance-pH -- SPT skin prick test -- VAS visual analogue scale; AET -- GERD -- Non-Allergic rhinitis -- Reflux disease; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2019.11.008
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Background & Aim: Chronic rhinitis, a diffuse disease with a prevalence of 40%, can be classified in allergic (AR) and non-allergic rhinitis (NAR). Nasal cytology allows for the identification of different NAR sub-types according to the inflammatory cell infiltrate. NAR etiopathogenesis is not well clarified and, for NARNE (non-allergic rhinitis with neutrophils) subtype, gastroesophageal reflux disease (GERD) has been suggested as one of the etiopathogenetic factors. Aim of this study is to evaluate the role of GERD in patients with NARNE. Methods: Fifty-one consecutive patients referred to our Ear, Nose and Throat (ENT) unit with nasal symptoms and cytology suggestive for NAR, were enrolled in the study. All the patients performed a gastroenterological evaluation, high resolution esophageal manometry and a 24-h pH-Impedance monitoring. Results: Twenty-five (49%) patients tested positive at nasal cytology for NARNE. A pathologic pH-impedance was identified in seven patients (28%) with NARNE, as opposed to only one (4%) with different NAR subtypes. Statistical analysis showed that higher acid exposure time (AET) and weaker post nasal drainage were more common in NARNE vs. other NAR patients. Conclusions: NARNE strongly correlates with higher AET and refluxes number; thus, NARNE patients should be tested with pH-impedance monitoring in addition to nasal cytology.