Do you look for local IgE production in the nares with negative SPT and IgE testing if the clinical history suggests AR and the patient desires AIT?  

I do not check for local IgE production or perform nasal allergen challenges for local allergic rhinitis. I just offer these patients the combination of a nasal steroid and nasal antihistamine.The 2020 Rhinitis Practice Parameter has a nice summary of local allergic rhinitis."While the literature su...