Accumulation of eosinophils in the nasal secretion in patients with bronchial asthma

: From October 1977 to September 1979 69 out of 500 asthmatic patients were selected in whom case histories, skin tests and IgE blood-levels formed a sub-group with more or less pure allergic asthma and a sub-group with more or less pure intrinsic asthma. All the patients exhibited a large quantity of granulocytes in the bronchial and nasal secretions. Special attention was paid to the contents of eosinophils in the nasal smear and in the bronchial mucus. The intrinsic subgroup had a (non significantly) greater incidence of 100% eosinophils in the bronchial secretion than the allergic sub-group (p less than 0.1). Unexpectedly, the reverse was found in the nasal secretions: only 33% of the intrinsics (9 cases) and as many as 67% of the allergics (28 cases) exhibited 100% eosinophils in the nasal mucus (p less than 0.025). Thus, when discussing the two forms of asthma, allergic and intrinsic, it is always necessary to bear in mind the possible paradoxical behaviour between nasal and bronchial mucus: pure eosinophilia in the lower respiratory tract may often be found concomitantly with pure neutrophilia in the upper respiratory tract, when some of the criteria for intrinsic asthma are fulfilled.