J Rhinol.  2024 Mar;31(1):17-21. 10.18787/jr.2023.00066.

Insufficiency of Laboratory Data in Reflecting Allergic Rhinitis Severity Based on the Allergic Rhinitis and Its Impact on Asthma Guideline in Korean Patients

• Noh HE
• Jeong Y
• Rha MS
• Kim CH
• Cho HJ

• KMID: 2554086
• DOI: http://doi.org/10.18787/jr.2023.00066

Abstract

Background and Objectives
This retrospective study, conducted at a single tertiary medical center, aimed to investigate the correlation between the severity of allergic rhinitis (AR) based on subjective symptoms and the severity assessed through laboratory data.
Methods
In total, 584 patients who were diagnosed with AR by a multiple-allergen simultaneous test were included. Patients were classified into four groups according to the Allergic Rhinitis and its Impact on Asthma (ARIA) classification guideline. The visual analog scale (VAS) score for overall discomfort and laboratory parameters, including the serum total immunoglobulin E (IgE) level and peripheral blood eosinophil count, were evaluated in all patients. An analysis was conducted to examine the differences in VAS scores and laboratory findings among the four groups. Additionally, the correlations between the laboratory findings and VAS score were analyzed.
Results
The serum total IgE level and the percentage and count of peripheral blood eosinophils showed no significant differences among the groups. However, the VAS score for overall discomfort exhibited notable between-group differences. The average VAS score was 6.14 (95% confidence interval 5.94–6.34) in the overall group. The mean scores of each group showed a noticeable increasing trend from the mild intermittent group to the mild persistent, moderate to severe intermittent, and moderate to severe persistent groups (p<0.001), although there was no clear correlation between the increase in VAS scores and laboratory parameters.
Conclusion
Neither the symptom-based ARIA guideline nor the VAS score correlated with the AR laboratory test measurements. The current laboratory data alone may not be sufficient to reflect the severity of AR based on subjective symptoms.

Keyword

Allergic rhinitis; ARIA guideline; Serum total IgE; Blood eosinophil count

Figure

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  Fig. 1. Serum total IgE and peripheral blood eosinophil count for each ARIA group. A: For the serum total IgE level, there was no significant difference between groups. B and C: The blood eosinophil count also showed no significant difference between groups. The Kruskal– Wallis test was applied for comparisons between groups (p>0.05). ARIA, Allergic Rhinitis and its Impact on Asthma; MI, mild intermittent; MP, mild persistent; M-S I, moderate to severe intermittent; M-S P, moderate to severe persistent.

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  Fig. 2. Visual analog scale (VAS) scores for overall discomfort caused by allergic rhinitis. All groups have significant differences each other (Kruskall–Wallis, p<0.001; Mann–Whitney, p<0.05). The VAS score showed a tendency to increase from the MI to the M-S P group (M-S P>M-S I>MP>MI; Jonckheere–Terpstra, p<0.001). MI, mild intermittent; MP, mild persistent; M-S I, moderate to severe intermittent; M-S P, moderate to severe persistent.

Reference

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