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Allergic Rhinitis
ℹ️ About
- Allergic rhinitis is an IgE-mediated hypersensitivity disorder of the nasal mucosa, triggered by allergens such as pollen 🌸, dust mites 🕷️, animal dander 🐶🐱, and moulds 🍄.
- Often occurs in patients with a personal or family history of atopy (eczema, asthma, allergic rhinitis).
🩺 Clinical Features
- Seasonal (hay fever): Symptoms worse in pollen season.
- Perennial: Year-round symptoms, often from dust mites or pets.
- Acute symptoms: Sneezing 🤧, watery rhinorrhoea, nasal blockage, itchy eyes and nose, tearing.
- Chronic findings:
- Postnasal drip, persistent congestion
- Allergic shiners (dark circles under eyes)
- Allergic salute & transverse nasal crease 👃
- Pale, boggy nasal mucosa on exam
🔎 Investigations
- Diagnosis is usually clinical.
- Specific IgE blood tests or skin prick testing can be useful if diagnosis uncertain or considering immunotherapy.
- Routine FBC or nasal smears are not usually required.
⚠️ Complications
- Acute or chronic sinusitis.
- Otitis media (especially in children).
- Sleep disturbance or obstructive sleep apnoea 😴.
- Asthma exacerbations.
- Nasal polyps (in longstanding disease).
💊 Management
- Avoidance: Limit allergen exposure where possible (pollen, pets, dust mite control, mould removal).
- First-line: Intranasal corticosteroids (fluticasone, mometasone, budesonide).
- Second-line: Non-sedating oral antihistamines (cetirizine, loratadine, fexofenadine).
- Adjuncts:
- Saline nasal irrigation 💧
- Short-term oral/nasal decongestants (use sparingly)
- Leukotriene receptor antagonists (e.g., montelukast) if coexistent asthma
- Specialist options: Allergen immunotherapy (subcutaneous or sublingual) for severe, resistant cases.
References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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