Allergic Rhinitis
An allergic reaction causing sneezing, congestion, and itchy eyes in response to inhaled allergens.
Emergency Management: Anaphylaxis if the allergen exposure is massive and systemic, though extremely rare for pure allergic rhinitis.
An IgE-mediated inflammatory disorder of the nasal mucosa triggered by allergen exposure.
Detailed Overview
Occurs when the immune system overreacts to airborne particles like pollen or pet dander, causing histamine release from mast cells. It significantly impacts quality of life, sleep, and work productivity.
Epidemiology & Demographics
Affects 10-30% of adults and up to 40% of children globally.
Etiological Mechanism
Airborne allergens such as tree/grass/weed pollens, dust mites, animal dander, and mold spores.
Primary Causes
Sensitization to specific environmental allergens.
Allergen cross-links specific IgE on mast cells in the nasal mucosa, triggering immediate degranulation (histamine release) leading to sneezing/itching/rhinorrhea. A late-phase reaction hours later is mediated by eosinophils and T-cells, causing sustained congestion.
Diagnostic Criteria & Guidelines
Clinical diagnosis based on characteristic symptoms upon allergen exposure. Confirmed by positive skin prick testing or specific IgE blood tests.
Intranasal corticosteroids (e.g., Fluticasone propionate 50 mcg, 2 sprays per nostril daily). Oral second-generation antihistamines (e.g., Cetirizine 10 mg daily or Loratadine 10 mg daily).
Second-Line & Adjunctive Therapy
Intranasal antihistamines (Azelastine). Leukotriene receptor antagonists (Montelukast 10 mg daily). Allergen immunotherapy (subcutaneous or sublingual) for long-term tolerance.
Surgical & Procedural Management
Turbinate reduction surgery or septoplasty if severe structural obstruction exacerbates symptoms.
Patient Counseling & Advice
Counsel that intranasal steroids take several days to reach maximal efficacy and must be used consistently, not just as needed.
Follow-Up & Monitoring Schedule
Follow up in 2-4 weeks to assess symptom control using validated questionnaires like RCAT.
Preventive Strategies
Allergen avoidance is the primary preventive measure.
Excellent, though it is a chronic condition requiring ongoing management. May wane in severity with advancing age.