Paradoxical Response to Cold Dry Air Provocation according to the Season in Allergic Rhinitis Patients

Background and ObjectivesWe investigated the seasonal variation of nonspecific hyperreactivity by performing the cold dry air (CDA) provocation test in both summer and winter in patients with rhinitis. Subjects and MethodWe performed the CDA provocation test in 57 patients with allergic rhinitis (AR) or non-allergic rhinitis (NAR).Depending on the season and the type of rhinitis, we divided patients into four groups (Summer AR group, n=17; Winter AR group, n=15; Summer NAR group, n=18 and Winter NAR group, n=7) and compared the changes in nasal symptoms, total nasal volume (TNV), and minimal cross-sectional area (MCA) measured by acoustic rhinometry after CDA provocation in each group. ResultsWhen the CDA provocation was performed for AR patients in summer, nasal symptoms improved slightly, which was significantly different from those shown in winter (Summer AR vs. Winter AR, p=0.012).In addition, there was a significant difference in symptom change between AR and NAR patients in the summer (Summer AR vs. Summer NAR, p=0.033).There was no significant difference in TNV or MCA changes after CDA provocation depending on the type of rhinitis and season (p＞0.05).Conclusion When performing CDA provocation in AR patients in summer, the examiner should pay attention to the possible paradoxical response.