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Updated: Dec 17 2021

Allergic Rhinitis

  • Snapshot
    • A 15-year-old boy presents with clear fluid discharge from his nose for 2 days duration. His also reports having episodes of sneezing, feelings of congestion, and a cough. His symptoms only occuring during the spring months and finds it difficult to walk outside without exacerbating his symptoms. On nasal exam, the mucosa and turbinates appear edematous.
  • Introduction
    • Definition
      • inflammation of the mucosa of the nasal passages
    • Rhinitis types
      • allergic rhinitis
      • nonallergic rhinitis
        • etiologies include
          • vasomotor
          • hormonal
          • drug-induced
          • occupational (secondary to irritant exposure)
          • pregnancy
    • Associated conditions
      • sinusitis
      • asthma
      • atopic dermatitis
      • allergic conjunctivitis
      • nasal polyps
  • Epidemiology
    • Incidence
      • allergic rhinitis is the most common form of rhinitis
  • Etiology
    • Aeroallergens
    • Pathogenesis
      • aeroallergens leads to an IgE type I hypersensitivity and mast cell degranulation
  • Presentations
    • Symptoms
      • sneezing
      • congestion
      • rhinorrhea
      • nasal itching
  • Studies
    • Making the diagnosis
      • this is a clinical diagnosis
    • Allergic skin testing
      • confirms that the patients has an allergy to the aeroallergen
        • is not necessary for the diagnosis
  • Differential
    • Nonallergic rhinitis
      • drug-induced rhinitis
        • differentiating factors
          • onset after starting the inciting medication (e.g., angiotensin-converting enzyme inhibitors and phosphodiesterase-5 inhibitors)
      • occupational rhinitis
        • differentiating factors
          • caused by allergens or irritants in the workplace
      • atrophic rhinitis
        • differentiating factors
          • seen in older patients who had many sinus and nasal surgeries
  • Treatment
    • Conservative
      • allergen avoidance
        • indication
          • a component of the management of rhinitis
    • Medical
      • glucocorticoid nasal sprays
        • indication
          • first-line treatment for persistent or moderate-to-severe allergic rhinitis
        • medications
          • budesonide
          • fluticasone
  • Complications
    • Respiratory tract infections
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