Chronic "vasomotor" rhinitis symptoms (nasal congestion, rhinorrhoea, volley of sneezing) present even outside the pollen season, in a patient skin prick test and/or RAST test positive. Increased "vasomotor"- type nasal reactivity to non-specific stimuli [sudden changes in temperature, light stimuli, strong smells, cigarette smoke, exposure to chlorine (swimming), etc.]. Disturbances of taste and smell (suspect onset of nasal polyposis). Positive family history of nasal polyposis, NARES, NARMA, NARESMA, asthma, sensitivity to acetylsalicylic acid, hypo-anosmia, vasomotor rhinitis labelled "non-specific", previous turbinate surgery for nasal congestion which gave poor medium- to long – term results. Recurrent use of nasal decongestants. Little or no clinical benefit following turbinate surgery for nasal congestion. Little or no clinical benefit following a cycle of specific immunotherapy (SIT). |
In the forms with "persistent" symptoms, overlapping should be suspected in all patients with rhinocytogram showing a cell profile different form that associated with "persistent minimal inflammation" (i.e. different from that characterized by numerous neutrophils, some lymphocytes and occasional eosinophils, with rare signs of degranulation), where there are eosinophils >; 20% and/or mast cells >; 10%. In the forms with "intermittent" symptoms, overlapping should be suspected in all patients with a positive rhinocytogram (eosinophils >; 20% and/or mast cells >; 10%.) outside the pollen season for the allergen/s identified by allergy testing (skin prick test and/or RAST test). In rhinocytology, November tends to be preferred for "unravelling" overlapping rhinopathies, as this is the month in which most airborne pollens are absent. The presence of immuno-inflammatory cells (eosinophils and/or mast cells) associated with rhinitis symptoms confirms the presence of overlapping diseases. |
