Page 63 - Portuguese Journal - SPORL - Vol 61. Nº1

Table 1 and, less frequently, animal hair and Olea
Etiologic classification of rhinitis (adapted from europaea (olive) . Nasal reactivity to several
3-5
Rondón et al. )
11
aeroallergens can occur, similar to what occurs
1. Allergic Rhinitis in AR 3,5,15 .
Rondón et al. demonstrated that patients with
Allergic Rhinitis (with systemic atopy)
LAR exhibit an eosinophilic infiltrate in the
Classic Classification
nasal mucosa after exposure to an aeroallergen,
Time of exposure to the aeroallergen: as well as a sudden increase and subsequent
perennial, seasonal, occupational
decrease in tryptase in the nasal secretions,
ARIA Classification 1 while the concentration of eosinophil cationic
Duration of the symptoms: persistent, protein (ECP) increases gradually in the
intermittent following 24 hours . Moreover, patients with
3,6
Severity of the symptoms: mild, moderate, LAR exhibit a significant increase in IgEs in the
severe nasal secretions within 24 hours after exposure
Local Allergic Rhinitis (without systemic atopy) to the aeroallergen . These immunological
3
Classic Classification findings indicate an underlying IgE-mediated
Time of exposure to the aeroallergen: pathological mechanism.
perennial, seasonal, occupational The presence of IgE in nasal secretions
ARIA Classification 1 of patients with LAR after exposure to
aeroallergens is detected in 22% to 35% of
Duration of the symptoms: persistent,
3,4
intermittent patients . This low detection rate of IgE
may be explained by the low sensitivity of
Severity of the symptoms: mild, moderate,
severe the diagnostic method used; therefore, the
measurement of IgE in nasal secretions is
2. Nonallergic Rhinitis
used solely for research purposes and not as a
Infectious
diagnosis method in clinical practice 3,4,16 .
Occupational The analysis of nasal secretions by flow
Induced by drugs cytometry in patients with LAR exposed to
Hormonal aeroallergens demonstrated a pattern of
inflammatory infiltrate similar to that seen
Irritant
in AR, with increased levels of eosinophils,
Gustatory
basophils, mast cells, and CD3 and CD4 T cells,
+
+
Emotional suggesting a T 2/IgE-mediated inflammatory
3,4
Atrophic response . H
NARES
3. Clinical manifestations:
Idiopathic
The symptoms of LAR are similar to those
of AR. Patients may present with nasal
2. LAR – Epidemiology and pathophysiology: congestion, rhinorrhea, sneezing, and nasal
LAR is more prevalent in Mediterranean itching. The latter three are more frequently

countries than in northern European and Asian reported in LAR 3-5 (Table 2). These patients
countries . The prevalence of LAR among may also exhibit other extra-nasal diseases
12
children has been little studied; however, the such as conjunctivitis and asthma. Most
existing studies show that it is similar to that patients with LAR report having persistent
among adults 12-14 . moderate to severe symptoms, associated
The allergens most frequently associated with with conjunctivitis and asthma (in up to 50%
LAR are house dust mites (Dermatophagoides of patients) 3-4,11 .
pteronyssinus), grasses, Alternaria alternata,

Volume 61 . Nº1 . March 2023 63