3052A Is Nasal Provocation Test Useful In Selecting Allergen for Immunotherapy In Children?

Tuesday, 6 December 2011
Poster Hall (Cancún Center)

Ilknur Bostanci , Clinic of Pediatric Allergy and Asthma, Dr.Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara, Turkey

Handan Duman , Clinic of Pediatric Allergy and Asthma, Dr.Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, , Ankara, Turkey

Serap Ozmen , Clinic of Pediatric Allergy and Asthma, Dr.Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara, Turkey

Mahmut Dogru, MD , Clinic of Pediatric Allergy and Asthma, Dr.Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara, Turkey

Background: Specific immunotherapy is the only recognized causal treatment of allergic diseases. Nasal provocation test (NPT) can be used for quantitative evaluation of sensitivity especially in patients sensitized to multiple allergens. There is no data related to routine use of nasal provocation test in selecting allergens for immunotherapy in children.  Here in we report our experience with nasal provocation test in evaluation of patients with allergic rhinitis (with/without asthma).

Methods: A total number of five patients were evaluated. Their age ranged between 97-189 months (130±42.75 months). Two of them had sensitivity to DP+ DF, two to cereal and grass, and one to cereal, grass, salicea, artemisia, olea and parieteria. One of them had symptoms (itching, sneezing) and a %40 increase in nasal resistance after application of only diluent. Allergen solutions were administered onto the mucosa with a nasal sprey in each nostril in increasing doses (1/1000, 1/100, 1/10, 1 concentration of different allergens). Symptoms (itching, sneezing, secretion, congestion, conjunctivitis, urticaria) and rhinomanometric measurement results were recorded. Provocation test was considered positive if, following allergen provocation, rhinomanometric examination revealed an increase in respiratory resistance or decrease in nasal flow by at least 40% in comparison with the control test.  A patient sensitized with DP and DF undergone the test secondly one week later

Results: Two patients had negative nasal provocation test and immunotherapy wasn’t initiated.  One of the patients sensitized with DP and DF had both symptoms and an increase during each test and immunotherapy with DP+DF mix was started. The last patient had a positive result with grass mix and immunotherapy with grass mix was started.

Conclusions: Nasal provocation test is useful in selecting the allergen or allergens for immunotherapy in the patients sensitized with multiple allergens. We think that nasal provocation test can be used as objective data for immunotherapy in the practice of pediatric allergists.