ABSTRACT
Background: Irritation symptoms after exposure to “nonspecific” stimuli are often attributed to nonallergic rhinitis (vaso-motor rhinitis). This is a heterogeneous syndrome of exclusion based on nasal symptoms with negative allergy skin tests.
Method: Control (n = 114) and Chronic Fatigue Syndrome (CFS, n = 120) subjects scored the severity of nasal congestion and rhinorrhea sensations that they attributed to 9 irritants. The sum was the “Irritant Rhinitis Score” (IRS maximum 72). A positive IRS of > 19 defined “Irritant Rhinitis.” Demographic, allergy skin test and other assessments were done to characterize the Irritant Rhinitis population.
Results: Irritant Rhinitis was present in 11% of control and 47% of CFS subjects. In multivariate analysis, positive IRS was correlated with a history of rhinitis complaints, systemic complaints such as fatigue, sensations of congestion and rhinorrhea induced by meteorological conditions, tobacco smoke, odors, perfumes, and other volatile materials, and diagnoses of CFS and Multiple Chemical Sensitivity (MCS). Although atopy was not correlated to Irritant Rhinitis, 51% of allergic rhinitis subjects had a positive IRS.
Conclusions: The Irritant Rhinitis Score defined a population with irritant-induced nasal congestion and rhinorrhea who also had significant systemic complaints. Similar neural mechanisms may underlie the spectrum of Irritant Rhinitis, CFS and MCS.