Date sent:      	Sun, 17 Dec 2000

Irritant Rhinitis in Allergic, Nonallergic, Control and Chronic Fatigue
Syndrome Populations

Journal of Chronic Fatigue Syndrome, Vol. 7(2) 2000, pp. 3-31

James N. Baraniuk, MD; Kristina Naranch, BA; Hilda Maibach, MS;
Daniel J. Clauw, MD

Division of Rheumatology, Immunology and Allergy, Department
of Medicine, Georgetown University, Lower Level Gorman Building, 3800
Reservoir Road, N.W., Washington, DC 20007-2197.  Address correspondence
to: James N. Baraniuk at the above address (E-mail:
mailto:baraniuj@gunet.georgetown.edu).

ABSTRACT.
Background: Irritation symptoms after exposure to “nonspecific” stimuli
are often attributed to nonallergic rhinitis (vasomotor 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.


KEYWORDS. Irritant Rhinitis, Vasomotor Rhinitis, Nonallergic Rhinitis,
Allergic Rhinitis, Multiple Chemical Sensitivity, Chronic Multisystem
Illness, Tobacco Sensitivity


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