Gustatory rhinitis in multiple system atrophy

Abstract Gustatory rhinitis is a type of nonallergic, noninflammatory rhinitis. A high incidence of rhinorrhea, including gustatory rhinitis, is reported in patients with Parkinson’s disease (PD). Herein, we report a case of gustatory rhinitis in a patient with a parkinsonian variant of multiple system atrophy (MSA-P). A 56-year-old man presented with gustatory rhinorrhea and bilateral copious nasal discharge while eating. Three years before visiting the ear, nose, and throat clinic, he developed Parkinsonism and was suspected of having MSA-P. He underwent posterior nasal neurectomy under endoscopic guidance, but it did not significantly reduce the rhinorrhea during eating. Pathological examination of the mucosa of the inferior turbinate demonstrated minimal inflammatory cellular infiltration. Severe (gustatory) rhinitis may also be a useful biomarker for the diagnosis of synucleinopathies, including PD and MSA, akin to anosmia, which is a well-known biomarker for the early diagnosis of PD.