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Nasal eosinophilia in nasal smears of patients with persistent and intermittent allergic rhinitis

  • G Berkiten (a1), İ Aydoğdu (a1), T L Kumral (a1), Z Saltürk (a1), Y Uyar (a1), A Arslanoğlu (a1), B Tutar (a1) and A E Göker (a1)...

Eosinophils are the principal effector cells involved in the pathogenesis of allergic rhinitis. Cell numbers increase in non-allergic rhinitis patients with eosinophilia, aspirin hypersensitivity and nasal polyposis, as well as in allergic rhinitis patients. Exfoliative nasal cytology can be used in the differential diagnosis of allergic rhinitis.


To evaluate nasal eosinophilia in nasal smears of patients with mild, persistent and intermittent allergic rhinitis.


The study comprised 60 patients with allergic rhinitis and 20 healthy volunteers. The patients were divided into intermittent and persistent allergic rhinitis groups. Nasal smear status, eosinophil numbers and Total Nasal Symptom Scores were compared.


Nasal smear results were pathological in 40 of 60 allergic rhinitis patients, which was significantly higher than the rate in controls. The mean nasal eosinophilia score was significantly higher in the intermittent allergic rhinitis than in the persistent allergic rhinitis group (p = 0.029). There was a positive correlation between nasal eosinophilia score and Total Nasal Symptom Score (r = 0.652; p < 0.05) in persistent allergic rhinitis and intermittent allergic rhinitis patients.


The nasal smear test is inexpensive, objective and simple to perform, and should be part of the diagnostic investigation.

Corresponding author
Author for correspondence: Dr Belgin Tutar, ENT Clinic, Okmeydanı Training and Research Hospital, Darülaceze cad. Şişli/Istanbul, Turkey E-mail:
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Dr B Tutar takes responsibility for the integrity of the content of the paper

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1Simons, FE. Allergic rhinitis: recent advances. Pediatr Clin North Am 1988;35:1053–74
2Nalebuff, DJ. Allergic rhinitis. In: Cummings, CW, Fredrickson, JM, Harker, LA, Krause, CJ, Schuller, DE, eds. Otolaryngology Head and Neck Surgery, 2nd edn. St Louis: Mosby Year Book, 1993;765–74
3International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet 1998;351:1225–32
4Liu, F, Zhang, J, Liu, Y, Zhang, N, Holtappels, G, Lin, P et al. Inflammatory profiles in nasal mucosa of patients with persistent vs intermittent allergic rhinitis. Allergy 2010;65:1149–57
5Bousquet, J, Khaltaev, N, Cruz, AA, Denburg, J, Fokkens, WJ, Togias, A et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008;63(suppl 86):8160
6Özgür, A, Arslanoğlu, S, Etıt, D, Demıray, U, Önal, HK. Comparison of nasal cytology and symptom scores in patients with seasonal allergic rhinitis, before and after treatment. J Laryngol Otol 2011;125:1028–32
7Salas, A, Wilson, N, Hamburger, RN. Relation of serum IgE level to the cells observed in the nasal cytograms. Ann Allergy 1988;60:175
8Lu, D, Zhao, Y, Zheng, Y, An, P, Wang, L, Qiao, X et al. Evaluation of quality of life questionnaires for adult patients with moderate to severe allergic rhinitis. Am J Otolaryngol 2011;32:494–8
9Jalowayski, A, Zeiger, RS. A Practical Guide for the Examination of Nasal Cytology in the Diagnosis of Nasal Disorders. San Diego: University of California, 1980
10Cohen, SG, Ottesen, EA. The eosinophil, eosinophilia, and eosinophil-related disorders. In: Middleton, E Jr, Reed, CE, Ellis, EF, eds. Allergy: Principles and Practice, 2nd edn. St Louis: CV Mosby, 1983;701
11Crobach, M, Hermans, J, Kaptein, A, Ridderikhoff, J, Mulder, J. Nasal smear eosinophilia for the diagnosis of allergic rhinitis and eosinophilic non-allergic rhinitis. Scand J Prim Health Care 1996;14:116–21
12Skoner, DP. Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. J Allergy Clin Immunol 2001;108(1 suppl):S28
13Boyce, JA, Broide, D, Matsumoto, K, Bochner, BS. Advances in mechanisms of asthma, allergy, and immunology in 2008. J Allergy Clin Immunol 2009;123:569–74
14Prussin, C, Metcalfe, DD. 5. IgE, mast cells, basophils, and eosinophils. J Allergy Cln Immunol 2006;117(2 suppl mini-primer):S450–6
15Sood, A. Diagnostic significance of nasal eosinophilia in allergic rhinitis. Indian J Otolaryngol Head Neck Surg 2005;57:1316
16Lans, DM, Alfano, N, Rocklin, R. Nasal eosinophilia in allergic and nonallergic rhinitis: usefulness of the nasal smear in the diagnosis of allergic rhinitis. Allergy Proc 1989;10:275–80
17Burrows, B, Hasan, FM, Barbee, RA, Halonen, M, Lebowitz, MD. Epidemiologic observations on eosinophilia and its relation to respiratory disorders. Am Rev Respir Dis 1980;122:709–19
18Jankowski, R, Persoons, M, Foliguet, B, Coffinet, L, Thomas, C, Verient-Montaut, B. Eosinophil count in nasal secretions of subjects with and without nasal symptoms. Rhinology 2000;38:2332
19Gelardi, M, Fiorella, ML, Russo, C, Fiorella, R, Ciprandi, G. Role of nasal cytology. Int J Immunopathol Pharmacol 2010;23(1 suppl):45–9
20Ahmadiafshar, A, Taghiloo, D, Esmailzadeh, A, Falakaflaki, B. Nasal eosinophilia as a marker for allergic rhinitis: a controlled study of 50 patients. Ear Nose Throat J 2012;91:122–4
21Nurkic, J, Ahmad, MA, Arifhodzic, N, Jusufovic, E. The role of target organ diagnostic approach in seasonal allergic rhinitis: nasal smear eosinophils. MaterSociomed 2016;28:125–8
22Bryan, MP, Bryan, WT. Cytologic diagnosis in allergic disorders. Otolaryngol Clin North Am 1974;7:637–66
23Malmberg, H, Holopainen, E. Nasal smear as a screening test for immediate-type nasal allergy. Allergy 1979;34:331–7
24Vaheri, E. Nasal allergy with special reference to eosinophilia and histopathology. Acta Allergol 1956;10:203–11
25Bhandari, CM, Baldwa, VS. Relative value of peripheral blood, secretion and tissue eosinophilia in the diagnosis of different patterns of allergic rhinitis. Ann Allergy 1976;37:280–4
26Okano, M, Nishizaki, K, Nakada, M, Kawarai, Y, Goto, S, Satoskar, AR et al. Prevalence and prediction of allergic rhinitis using questionnaire and nasal smear examination in schoolchildren. Acta Otolaryngol Suppl 1999;540:5863
27Perić, A, Vojvodić, D, Vukomanović-Durdevid, B. Influence of allergy on clinical, immunological and histological characteristics of nasal polyposis. B-ENT 2012;8:2532
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  • EISSN: 1748-5460
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