Allergic rhinitis
- Summary 3
- Basics 4
- Definition 4
- Epidemiology 4
- Aetiology 4
- Pathophysiology 5
- Classification 5
- Prevention 7
- Primary prevention 7
- Secondary prevention 7
- Diagnosis 8
- Case history 8
- Step-by-step diagnostic approach 8
- Risk factors 9
- History & examination factors 12
- Diagnostic tests 13
- Differential diagnosis 15
- Diagnostic criteria 16
- Treatment 17
- Step-by-step treatment approach 17
- Treatment details overview 21
- Treatment options 23
- Emerging 45
- Follow up 46
- Recommendations 46
- Complications 46
- Prognosis 47
- Guidelines 49
- Diagnostic guidelines 49
- Treatment guidelines 49
- Evidence scores 51
- References 52
- Disclaimer 59
Summary
◊ Presumptive diagnosis of allergic rhinitis may be made in the presence of nasal congestion, sneezing, and itchy nose/palate/eyes with a pattern of allergic triggers.◊ Definitive diagnosis would require specific IgE reactivity during skin-prick or in vitro testing, but a trial of therapy may be ordered on the basis of a presumptive clinical diagnosis.
◊ Treatment consists of allergen avoidance where possible and pharmacotherapy (antihistamines, corticosteroids, cromoglicate, decongestants, leukotriene receptor antagonists). Immunotherapy may be an option in patients with persistent symptoms.
◊ Intranasal corticosteroids remain the single most effective class of medications for treating allergic rhinitis.
◊ Reducing exposure to environmental allergens (e.g., dander, dust mites, and tobacco smoke) is an important measure for patients sensitive to these items, and can often be recommended empirically based on the patient’s history.