Table 4

Practical aspects of ASNC

PURPOSES

CONTRAINDICATIONS

Demonstration of the causal role of an allergen

Identification of the most relevant allergen(s)

Evaluation of the effect of a treatment

Investigating the inflammatory phenomena (research)

Occupational rhinitis

Acute bacterial or viral rhinosinusitis.

Acute exacerbation of allergic disease.

History of previous anaphylactic reaction

Severe general diseases

Pregnancy

Polyps

Recent ENT surgery (6-8 wks)


CAUSES OF FALSE POSITIVE

CAUSES OF FALSE NEGATIVE

Nasal cycle

Recent exposure to irritants

Rhinosinusitis

Priming effect

Weak extract

Drugs

nasal antihistamine (1 day withdrawal)

oral antihistamine (3 day withdrawal)

nasal steroid (7 day withdrawal)


GENERAL PROCEDURE

Let the patient be adapted to room temperature

Inspect nasal cavity

Spray or apply saline as negative control

Perform measurement(s)

Instruct to avoid nasal breathing

Apply the allergen into one nostril and re-evaluate after 10-15 minutes

Proceed on with increasing concentration in the other nostril

Use both active and plasebo tests for diagnosis for occupational rhinitis

Scadding et al. Clinical and Translational Allergy 2011 1:2   doi:10.1186/2045-7022-1-2

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