小结
定义
病史和体格检查
关键诊断因素
- sneezing
- nasal pruritus
其他诊断因素
- palate, throat, ear, and eye itching
- eye redness, puffiness, and watery discharge
- fatigue and irritability
- nasal congestion
- rhinorrhea
- allergic shiners
- conjunctival injection
- ocular mucoid discharge
- nasal crease
- pale nasal mucosa
- swelling of the nasal mucosa and turbinates
- abundant clear nasal secretions
- Dennie-Morgan lines (creases present under the lower eyelids)
危险因素
- other atopic conditions or family history of atopy
- age <20 years
- exposure to aeroallergens (pollen, molds, house dust mites, pollution)
- exposure to animal dander
- ethnicity
- positive allergen skin-prick tests
诊断性检查
首要检查
- therapeutic trial of antihistamine or intranasal corticosteroid
Tests to avoid
- immunoglobulin G (lgG) testing
- sinonasal imaging
需考虑的检查
- allergen skin-prick testing
- in vitro specific IgE determination
治疗流程
mild or intermittent symptoms
persistent and moderate to severe symptoms
usual therapy ineffective or poorly tolerated
撰稿人
作者
Gary C. Steven, MD, PhD, CPI, FAAAAI, FACAAI, FAPCR
Medical Director
American Academy of Allergy, Asthma & Immunology Registry
Assistant Clinical Professor of Medicine
Medical College of Wisconsin
Adjunct Clinical Instructor
College of Nursing
University of Wisconsin-Milwaukee
Allergy, Asthma & Sinus Center
Milwaukee
WI
利益声明
GCS has taken part in sponsored research for the ALK clinical trial of the house dust mite SLIT tablet for use in pediatric patients. He is a member of the Joint Task Force on Practice Parameters Workgroup on the Allergic Rhinitis Practice Parameter.
鸣谢
Dr Gary C. Steven would like to gratefully acknowledge Dr Alexander Greiner, a previous contributor to this topic.
利益声明
AG has received grant/research support from: AstraZeneca; Boehringer Ingelheim; Cephalon Circassia Ltd; Clement Clarke Cytos biotechnology; GlaxoSmithKline; Glenmark Specialty, S.A.; Hoffman-LaRoche/Genentech; HRA/Novartis; Janssen Research & Development; Kalypsys , Inc.; Lupin; Merck; Mylan Pharmaceuticals, Inc.; Nestle (Nestec Ltd); Novartis Ono Pharmaceutical Co., Ltd.; Perrigo; Rigel Pharmaceuticals, Inc.; Roxane Laboratories Inc.; Shionogi Inc.; Sunovion TEVA Branded Pharmaceutical Products; UBC (United Biosource Corporation)/Amgen Pharmaceuticals; and sponsorship for pharmaceutical trials from Allergen Research Corporation/Aimmune Therapeutics, Inc. and AstraZeneca.
同行评议者
Mark Davis-Lorton, MD
Clinical Immunology Coordinator
Division of Rheumatology, Immunology and Allergy
Winthrop-University Hospital
Mineola
NY
利益声明
MDL declares that he has no competing interests.
Glenis Scadding, MD
Consultant Allergist/Rhinologist
Allergy & Rhinology Department
Royal National Throat, Nose and Ear Hospital
London
UK
利益声明
GS is a consultant/advisory board member for ALK, Britannia Pharmaceuticals, CMP Therapeutics, Grupo Uriach, GSK, Merck, Sanofi-Aventis, Schering Plough, and UCB. She has received research funds from ALK, GSK, UCB, and Schering Plough. She has given talks for ALK, GSK, Merck, Schering Plough, and UCB and has co-written articles for Schering Plough and GSK.
鉴别诊断
- Nonallergic rhinitis
- Acute sinusitis
- Chronic sinusitis
更多 鉴别诊断指南
- Clinical practice guideline: immunotherapy for inhalant allergy
- Australasian guidelines for allergic rhinitis 2022
更多 指南患者教育信息
Hay fever
Hay fever: avoiding pollen and mold
更多 患者教育信息
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