Original Research Article
Year: 2018 | Month: June | Volume: 5 | Issue: 6 | Pages: 18-23
Quantitative Nasal Eosinophilia: An Objective Tool to Optimize Intranasal Topical Steroid Spray in the Management of Perennial Pediatric Allergic Rhinitis
Jyotindra Narayan Goswami1, Manoj Kumar Kanzhuly2, Salil Kumar Gupta3, Puneet Baveja4
1Asisstant Professor, Department of Paediatrics, Army Hospital (Research & Referral), Delhi Cantt, Delhi, India
2Assistant Professor, 3Senior Resident,
Dept of Otorhinolaryngology and Head & Neck Surgery, Armed Forces Medical College, Wanowari, Pune.
4Assistant Professor (Pathology), Office of Director General Armed Forces Medical Services, New Delhi.
Corresponding Author: Manoj Kumar Kanzhuly
Introduction: Persistent allergic rhinitis (AR) mandates long term use of intranasal corticosteroid sprays (INS) which pose a potential risk in children, especially when administered in higher dosages. There seems to be no objective method present for dose optimization other than subjective symptomatology reduction. Quantitative nasal eosinophilia (QNE) is an objective tool where nasal mucosal eosinophil count is measured by an easily obtainable nasal smear and can be used for INS dose optimization in paediatric persistent AR. In this study we aim to correlate QNE and Total Symptom Score 6 (TSS 6) before and after 2 and 4 weeks of treatment with INS in cases of pediatric AR.
Methods: 300 children of age group 5-15 years, diagnosed as having AR and fulfilling the inclusion criteria were enrolled and Mometasone INS was started in appropriate dosages. TSS 6 and QNE were measured before and post Mometasone INS treatment at 2 and 4 weeks and results were then correlated and analysed.
Results: Pre treatment median QNE scores were +1 and +2 which decreased to less than +2 at 2 weeks and +0.5 at the end of 4 weeks post treatment. TSS 6 values decreased from 9 – 11 (pre treatment) to 1-3 after 4 weeks of treatment. This result was statistically highly significant.
Conclusion: Intranasal steroid spray in pediatric perennial Allergic rhinitis can be titered to lower levels of optimal dosing, guided subjectively by symptom relief and objectively by applying a simple procedure of Quantitative nasal eosinophilia ideally suited in the pediatric age group.
Key words: Quantitative Nasal Eosinophilia; Total Symptom Score 6, Pediatric allergic rhinitis; Intranasal corticosteroid spray[PDF Full Text]