Autonomic nervous system dysfunction and the effect of vitamin D level in vasomotor rhinitis patients

Abstract

Background: Considering the role of the autonomic nervous system in thermoregulation, studies showing that it plays an important role in the pathophysiology of vasomotor rhinitis triggered by temperature exchange has been known for a long time. The aim of the present study was to evaluate patients with vasomotor rhinitis who have no organic causes for symptoms of thermodysregulation such as chills, hot flashes/sweating, and to determine the effect of regulator hormone vitamin D on symptoms of rhinitis and thermoregulation. Method: Between January to December 2019, a total of 183 patients were diagnosed with non-allergic persistent rhinitis. Smoking history and drugs used has been questioned. Allergy tests were performed with either a skin prick test or specific IgE measurement. Patients were evaluated for endocrinological diseases, anemia, vitamin D levels. Presence of nasal polyposis was evaluated with anterior rhinoscopy. Cuurently there is no validated test method that can show autonomic dysfunction. We prepared a questionnaire consisting of 24 questions that evaluates thermodysregulation and used it in this survey. Results: Of the 183 patients, 130 patients were evaluated as vasomotor rhinitis. The distribution of patients by gender was 26 men and 104 women. All patients had persistent moderate to severe rhinitis. A total of 81 (62%) patients had cold intolerance and 49 (38%) had heat intolerance. Of the patients with cold intolerance 76 stated that their complaints have increased upon sudden decrease in external environmental temperature. All patients with heat intolerance were complaining of excessive sweating.The demographic characteristics and laboratory tests of the patients are shown in Table 1. With regular sports activities, 24 patients reported decreased rhinitis symptoms. Of the patients with vasomotor rhinitis, symptoms of rhinitis decreased in 42 (32%) with sunbathing. A total of 69 (53%) patients received vitamin D replacement therapy. All of these patients stated that their complaints decreased after vitamin D replacement. The patients ' life styles and treatments are shown in Table 2. Conclusion: We showed that the coexistence of vasomotor rhinitis and thermoregulation disorder is common. We think that thermoregulation disorder may be due to autonomic nerveous system dysfunction and may share common mechanisms with vasomotor rhinitis.