Nasal Allergen Provocation Test (NAPT)

How does the test work?

During the NAPT, an allergen is applied to the nasal mucosa, which can trigger symptoms, such as:

• nasal congestion
• itching
• sneezing
• a runny nose

These symptoms usually appear within a few minutes and are most severe during the first hour.

The test takes about an hour. This includes a 30-minute observation period after the test.

Before the test

Before the test, you will be asked to sign an informed consent form, which details the procedure and the potential risks involved.

The test is preferably carried out outside the allergy season.

For an optimal performance of the test, you must stop all nasal medication one week in advance. The medication list will be reviewed with you once more beforehand. If you have an appointment for a NAPT, you will receive information via the Mynexuzhealth online medical record about which medicines you need to stop taking and how far in advance.

You may continue to use inhalers for asthma.

The test will take place in the morning, and for 24 hours prior to the examination, you may not consume alcohol, coffee, tobacco, or spicy food.

During the test

1. First, you’ll be given 15 minutes to acclimatise to the examination room.
2. Your symptoms will be evaluated and scored using a questionnaire.
3. Before and after each provocation, a Peak Nasal Inspiratory Flow test (PNIF), a rhinomanometry, and an acoustic rhinometry will be performed.
4. You will then receive two puffs in each nostril. The first administration is a control measurement using an aqueous solution; from the second measurement onwards, the allergen is applied.
5. Every ten minutes, we’ll ask you to score your symptoms and complaints.
6. If a clear allergic reaction occurs, we will stop the test.
7. The test concludes with a final assessment of the symptoms and a final measurement via PNIF, rhinomanometry, and acoustic rhinometry.

After the test

After the end of the test, you will remain under medical supervision for a further 30 minutes. An allergic reaction can sometimes occur later. If you experience a reaction after the test, please report this to the treating team.

At the end of the test, you will be informed whether the result is positive or negative. Your GP or referring physician will receive the result via the electronic patient record.

When can the test not go ahead?

The test will not be performed:

• if you have previously experienced anaphylactic shock caused by the allergen we are testing for
• if you have an upper respiratory tract infection
• if you suffer from uncontrolled asthma or chronic obstructive pulmonary disease (COPD)
• if you have a malignant tumour or an autoimmune disease
• if you are receiving systemic immunotherapy
• if you are pregnant

In some situations, we will postpone the test:

• until one week after a vaccination
• for 6 to 8 weeks after surgery of the nose or paranasal sinuses
• if you have recently consumed tobacco, alcohol, coffee or spicy food

Are you unsure whether you can have the test? If so, please discuss this with your healthcare provider beforehand.

Are there any risks?

A nasal allergen provocation test is a safe test. Although it has never been reported in medical literature, there is a theoretical risk that the NAPT could cause a severe allergic reaction.

Should a severe reaction occur, the doctors will immediately administer medication to treat it.

If you experience severe symptoms in the days following the test, please contact the allergy nurse.