A 28-year-old woman has perennial sneezing, watery rhinorrhoea and nasal itching with negative skin prick tests and normal total IgE. Nasal cytology shows marked eosinophilia. Which diagnosis fits best?

• A Vasomotor rhinitis
• B Rhinitis medicamentosa
• C Atrophic rhinitis
• D Non-allergic rhinitis with eosinophilia syndrome (NARES) ✓

Explanation

NARES presents with perennial allergic-type symptoms, absent atopy on testing, and prominent eosinophils on nasal smear. Patients often respond well to intranasal corticosteroids and have a tendency toward aspirin sensitivity and polyposis. Vasomotor rhinitis shows neutrophils or no eosinophilia on cytology, which is precisely the feature that separates it from NARES here.

Reference: Scott-Brown's Essential Otorhinolaryngology, 2nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.