Allergic rhinitis

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 is often an option in patients with persistent symptoms.

Reducing exposure to environmental allergens (e.g., dander, dust mite, and pollen) is an important measure for patients who are sensitive to these items, and can often be recommended empirically based on the patient's history.

Intranasal corticosteroids remain the single most effective class of medications for treating allergic rhinitis.

Allergic rhinitis (AR) is a common, yet under-appreciated inflammatory condition of the upper respiratory tract, characterised by nasal pruritus, sneezing, rhinorrhoea, and nasal congestion, the last of which is often deemed the most bothersome symptom. Frequently, there is associated palate, throat, ear, and eye itching as well as eye redness, puffiness, and watery discharge. AR is most often mediated by an IgE-associated response to ubiquitous indoor and/or outdoor environmental allergens, but is sometimes due to occupational or hobby exposures to proteins that do not commonly provoke IgE-mediated responses. Examples include woodworkers becoming sensitised to wood dusts, or food service workers becoming sensitised to grain dusts.