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• W2184575638 abstract "According to the more recent guidelines,allergen specificimmunotherapy (SIT), can be prescribed in rhinocon-junctivitis and/or asthma, if an IgE mediated mechanismis well ascertained,if the causal role of a given allergen isuncontrovertibly demonstrated,if the disease is not prop-erly controlled by medications,when an effective allergenavoidanceisnotfeasible(1).Inparticular,thecause/effectrelationship between the responsible allergen and theclinical manifestations is crucial for a successful outcomeof the treatment. This association can be easily demon-strated, for instance in patients monosensitized to apollen allergen, since symptoms will be present only dur-ing the pollen season. On the other hand, polysensitiza-tion and overlapping pollen seasons may make difficultthe choice of the proper allergen extract (2). In patientsallergic to pets or house dust mite, the intermittent pres-enceofsymptomsduringthewholeyearisnotnecessarilya reliable diagnostic criterion for the prescription of SIT.In addition,especially in adults,concomitant upper respi-ratory diseases (e.g. rhinosinusitis, polyps, septal devia-tion, adenoid hypertrophy) should be ruled out, sincetheir presence can be responsible for the failure of SIT(3). A recent study reports the prevalence of co-morbidi-ties (history of polyps & sinusitis) in HDM-allergic sub-jects and the little influence of this data on SIT prescrip-tion(4).In this observational study we assessed the decision-makingroleofnasalendoscopyintheprescriptionofSITin patients with house dust mite sensitization. One hun-dred and fifty seven patients (102 male, age range 18-60years), suffering from moderate/severe persistent rhinitis(5) were included. They had to have positive skin pricktest (mean wheal diameter > 5mm) and/or positive CAP-RAST (> 0.35 kU/L) to house dust mite. Nasal obstruc-tion was present in 82%, rhinorrhea in 76%, sneezing in73% and smell impairment in 19% of the patients. All ofthem were not fully controlled by house dust avoidancemeasures and pharmacotherapy. Only 16 (10.1%) weremonosensitized to house dust mite. No contraindicationto SIT was documented and, therefore, all where eligiblefor SIT according to guidelines. All subjects underwentnasal endoscopy with a fiberoptic rhinoscope (Pentax LH10 RP3, light source Pentax LH 150 II). At the end ofthe endoscopic procedure, the final diagnosis was sharedbyanallergistandanENTspecialist.Abnormalendosco-pic findings were observed in 52% of patients,being sep-" @default.
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• W2184575638 date "2013-08-01" @default.
• W2184575638 modified "2023-09-26" @default.
• W2184575638 title "The role of nasal endoscopy in the prescription of allergen immunotherapy." @default.
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