Eosinophilic reaction in nasal cytology in patients sensitive to perennial and seasonal allergens.

Nasal exfoliative cytology is a complementary tool in diagnostics of allergic (AR) and non-allergic (NAR) rhinitis. The aim of the study was to determine the usefulness of the nasal cytology in patients sensitive to common inhalant allergens with positive SPT(+) and negative SPT(-) (Skin Prick Tests) depending on the symptoms of intermittent and persistent rhinitis. The study was performed in a group of 285 patients treated in the Department of Allergology University Hospital in Krakow, suspected on AR in 2008-2010. The patients were made a smear test of inferior nasal concha. The samples were stained using the eosin-hematoxylin method and examined under a light microscope (1000x). Patients were divided into two groups: SPT(+) (144 patients) and SPT(-) (141 patients). Depending on the percentage of obtained eosinophils each group was divided into three subgroups: 0-2%, 3-20%, >20%. In the most percentage of patients with 3-20% of eosinophils in nasal cytology were found, in both studied groups (SPT)(+) and (SPT)(-), while the highest percentage of eosinophils (> 20%) was observed in the bigger group of patients with SPT(+), than with SPT(-). The number of patients with eosinophils > 20% in the SPT(+) group was higher in patients with persistent symptoms (NS differences), while in the SPT(-) group, the number of patients with intermittent symptoms in the subgroup > 20% of eosinophils statistically prevailed (p<0.001). The mean percentage of eosinophils in both groups was comparable, while the statistically significant differences were found considering the distinguished subgroups. In intermittent SPT(+) group the most sensitizing allergens were pollen grains (birch or grass pollen), while the patients with persistent AR symptoms were mainly sensitive the house dust mites. The mean percentage of eosinophils in an exfoliative cytology correlated significantly with allergic rhinitis symptoms and SPT results, the most evident relationship was found between higher level of eosinophils and the patients with confirmed AR diagnosis on the basis of positive SPT, manifesting the intermittent symptoms.