Perennial
rhinitis may be caused by an allergic response or by the vasomotor reaction to
cholinergic hyperactivity. The differential diagnosis of these etiologic forms poses a difficult problem for the clinicians. The pathophysiology of
rhinitis is characterized by vascular ingurgitation and mucous
edema, phenomena which may result from such diverse etiologic factors as
cholinergic hyperactivity and
allergy. In our study, we will evaluate total
IgE levels in nasal secretions, irrespective of serum of local origin. Fifty-four patients suffering from perennial
rhinitis, aged between 7 and 63 years, were studied. Fourteen presented
vasomotor rhinitis, while the remaining 40 were affected with the
IgE-dependent form. The following tests were done: blood eosinophil count, mucous eosinophyl count, serum
IgE (PRIST), cutaneous tests with
house dust, acarus and
fungal antigens and nasal provocation tests.
IgE levels in mucous were also evaluated. The following results were obtained: 1. No significant differences were found in blood eosinophil counts between the groups studied. 2. No significant differences were found in serum
IgE levels between the groups studied. 3. Significant differences were found (P less than 0.001) in the levels of eosinophils in mucous among the groups studied. 4. Mucous
IgE levels are significantly greater in the allergic form than in the vasomotor form of
rhinitis. The level of
IgE in mucous serves as a useful but not pathognomic parameters in the differential diagnosis of the different etiologic forms of
rhinitis. As such it should be considered within the context of all clinical and analytic data before a conclusive diagnosis is made.