Usefulness of nasal provocation test in the diagnosis of mite allergic rhinitis: Standard or rapid?

Introduction: Diagnosis of mite allergic rhinitis is often difficult. Limited studies of Standard Nasal Provocation Test (SNPT) against mites have shown that 13 to 30 % of rhinitics sensitized to mite had a negative NPT. Moreover, SNPT is time consuming and impractical in routine. Objective : Determine the sensitivity and specificity of SNTP, and compare it to the "rapid" nasal provocation test (RNTP). Materials and Methods : 91 patients with allergic rhinitis (52 sensitized to mites and 39 controls sensitized to other allergens or non atopic) were included mean age of 26 years. All patients had a SNTP and a RNTP separated at least for 4 weeks with Stallergènes Dpt extracts (Der p 1 content: 7.9 mg / ml for 100 IR) The SNTP was positive if the nasal resistance increased more than 100% and / or if the clinical score was more than 5 points (score of Lebel-Bousquet). The RNTP was positive if the (Lebel Bousquet score) was greater than 5 points. Results : 27 men and 64 women were included. Skin prick tests to Dpt was 6.8 mm (+ / - 2.6). The duration of SNTP averaged 4 hours and 30 minutes for RNTP. The sensitivity and specificity of SNTP were the same, 94.4%. RNTP sensitivity was lower (83.7%). No serious side effects occurred with the 2 tests. Conclusion : 1) We have validated SNRP in a young population susceptible to be candidate for immunotherapy. 2) RNTP could replace SNTP with less sensitivity, with no safety issue. 3) Could become a tool for pulmonologist to select patients for desentization to mite. Study supported by Stallergènes Laboratories ®.