The results are in!

AP here:
Dr.Gonzalez called this morning to give me the results of Tonkas biopsies from the rhinoscopy.
Diagnostic findings and information:

Nasal biopsies: Mild lymphoplasmacytic rhinitis, left and right
The results were suggestive of mild lymphoplasmacytic rhinitis in both nasal passages. This type of inflammation can be seen with allergies or an autoimmune rhinitis. However, the changes were mild, so it is difficult to say if this could be the cause for the rhinitis. However, rhinitis can results in epistaxis in some cases. No obvious infection or cancerous changes were noted on biopsy.

The recommendation would be to start a course of corticosteroids (prednisone) to treat the inflammation noted to see if this helps with the intermittent epistaxis. If the epistaxis persists and no improvement is noted with the steroid, we discussed that the next step in trying to manage the epistaxis would be to consider ligation of the carotid artery or referral to U. Penn to discuss embolization therapy for epistaxis.

The plan at this time is to continue the antihistamine and to start a course of prednisone.

Assessment:

1) Intermittent epistaxis

2) Mild lymphoplasmacytic rhinitis

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