Clinical characteristics associated with conjunctival inflammation in allergic rhinoconjunctivitis

J Allergy Clin Immunol Pract. 2015 May-Jun;3(3):387-91.e1. doi: 10.1016/j.jaip.2015.01.006. Epub 2015 Jan 26.

Abstract

Background: Allergic rhinitis affects up to 30% of the general population worldwide and is increasing in prevalence. Among several comorbidities, conjunctivitis is probably the most common and occurs so frequently with allergic rhinitis that the term allergic rhinoconjunctivitis (ARC) has been coined.

Objectives: The cytological characteristics of conjunctival inflammation in patients with ARC were assessed and then correlated to clinical characteristics.

Methods: Fifty-one patients with clinically diagnosed ARC (23 men; 32.4 ± 13.5 years old) underwent a detailed clinical history and standard diagnostic allergy workup as well as nasal and conjunctival scraping for cytological analysis. Patients were subdivided into 3 groups on the basis of cytological phenotype: (1) nasal and conjunctival inflammation, (2) nasal inflammation only, and (3) no mucosal inflammation.

Results: Group 1 patients reported significantly higher eye itching scores (5.8 ± 2.9 on a 0-10 scale) than did patients in group 2 (3.8 ± 2.8; P = .06) or 3 (2.6 ± 2.9; P = .018) and were mostly men (81.8%). Male sex (odds ratio, 8.4; P = .005) and eye itching (odds ratio, 1.3; P = .019) significantly correlated with conjunctival inflammation. The odds of exhibiting conjunctival inflammation, at multivariate analysis, increased 13-fold for men and 1.5-fold for each point on the eye itching scale. A cutoff value of 3 or more for eye itching effectively identified patients with conjunctival inflammation.

Conclusions: Our study demonstrates that some clinical manifestations of ARC correlate well with conjunctival inflammation.

Keywords: Allergic rhinoconjunctivitis; Conjunctival cytology; Nasal cytology; Scraping.

MeSH terms

  • Adult
  • Chi-Square Distribution
  • Comorbidity
  • Conjunctiva / immunology*
  • Conjunctiva / pathology
  • Conjunctivitis, Allergic / diagnosis*
  • Conjunctivitis, Allergic / epidemiology
  • Conjunctivitis, Allergic / immunology
  • Conjunctivitis, Allergic / pathology
  • Cytodiagnosis
  • Female
  • Humans
  • Intradermal Tests
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nasal Mucosa / immunology*
  • Nasal Mucosa / pathology
  • Odds Ratio
  • Predictive Value of Tests
  • Pruritus / diagnosis
  • Pruritus / immunology
  • Rhinitis, Allergic / diagnosis*
  • Rhinitis, Allergic / epidemiology
  • Rhinitis, Allergic / immunology
  • Rhinitis, Allergic / pathology
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors
  • Young Adult