411 The Classification of Allergic Rhinitis and Its Cytological Correlate

BACKGROUND: The ARIA document introduced a new classification of allergic rhinitis, based on its duration and severity, which is graded on the basis of the impact of AR on daily activities and quality of life. Nasal cytology is a simple and reliable diagnostic tool to identify the presence and type of inflammation in rhinitis. Thus, we assessed severity of AR by nasal cytology on the basis of the ARIA classification. METHODS: Patients suffering from AR caused by grass pollen only, and healthy subjects were studied. The severity of rhinitis was defined according to ARIA. All subjects underwent nasal cytology, using a Rhino-probe. Scrapings were air-dryied and stained by May-Grunwald-Giemsa. Differential cell count was expressed as % of the total leukocytes. Unpaired t test was used for comparisons. RESULTS: Sixty-two grass-allergic patients (34 men, mean age 35.2 years) and 18 healthy subjects (10 men, mean age 32) were studied. 67.8% of patients had intermittent AR (33.9% mild and 33.9% moderate-severe) and 32.2% had persistent AR (14.5% mild and 17.7% moderate-severe). The patients with moderate-severe AR had significantly more mast cells and lymphocytes than those with mild AR, with a relatively smaller number of neutrophils and eosinophils. Mast cells and/or lymphocytes could be detected in only 3/30 patients with mild rhinitis, and in 19/32 patients with moderate/severe rhinitis. No difference in cell counts was found when comparing intermittent and persistent AR. CONCLUSIONS: Moderate/severe allergic rhinitis displays a cytological inflammatory pattern different from mild rhinitis.