++
Source: May JR. Allergic rhinitis. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=134128639. Accessed March 28, 2017.
+++
CONDITION/DISORDER SYNONYMS
++
++
++
Seasonal: Occurs in response to specific allergens (pollen from trees, grasses, and weeds) present at predictable times of year (spring and/or fall blooming seasons).
Perennial: Occurs year-round in response to nonseasonal allergens (eg, dust mites, animal dander, and molds).
Many patients have both types, with symptoms year-round and seasonal exacerbations.
++
Airborne allergens inhaled into nose processed by lymphocytes, producing immunoglobulin E (IgE).
Within seconds to minutes, rapid release of mediators (histamine, leukotrienes, prostaglandin, tryptase, kinins) causes:
Histamine produces:
Rhinorrhea.
Itching.
Sneezing.
Nasal obstruction.
Late-phase reaction 4–8 hours after initial exposure may cause chronic symptoms, including nasal congestion.
++
One of the most common disease affecting adults and the most common chronic disease in children in the United States.
Prevalence of seasonal rhinitis between 1% and 40%; perennial rhinitis prevalence ranges from 1% to 13%.
+++
PREVENTION AND SCREENING
++
++
Genetics.
Allergen exposure.
+++
CLINICAL PRESENTATION
++
Clear rhinorrhea; sneezing; nasal congestion; postnasal drip (occasionally with cough or hoarseness); allergic conjunctivitis; and pruritic eyes, ears, or nose.
May be loss of smell or taste, with sinusitis or polyps underlying cause in many cases.
Untreated rhinitis may lead to:
Complications include recurrent and chronic sinusitis and epistaxis.
+++
MEANS OF CONFIRMATION AND DIAGNOSIS
++
Medical history for:
Description of symptoms.
Environmental factors and exposures.
Results of previous therapy.
Use of medications.
Previous nasal injury or surgery.
Family history.
++
+++
DIAGNOSTIC PROCEDURES
++
+++
DIFFERENTIAL DIAGNOSIS
++