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Rinite alérgica

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 13 Jul 2025
Última atualização: 21 Mar 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • espirros
  • prurido nasal
Detalhes completos

Outros fatores diagnósticos

  • prurido em palato, garganta, ouvido e olhos
  • vermelhidão dos olhos, edema e lacrimejamento
  • fadiga e irritabilidade
  • congestão nasal
  • rinorreia
  • olhos arroxeados devido à alergia
  • hiperemia conjuntival
  • secreção ocular mucoide
  • prega nasal
  • palidez da mucosa nasal
  • inchaço da mucosa nasal e dos cornetos
  • secreções nasais claras e abundantes
  • linhas de Dennie-Morgan (pregas presentes nas pálpebras inferiores)
Detalhes completos

Fatores de risco

  • outras afecções atópicas ou história familiar de atopia
  • idade <20 anos
  • exposição a aeroalérgenos (pólen, bolor, ácaro, poluição)
  • exposição a pelos/penas de animais
  • etnia
  • testes de punção cutânea positivos para alérgenos
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • tentativa terapêutica de anti-histamínico ou corticosteroide intranasal
Detalhes completos

Investigações a serem consideradas

  • teste de punção cutânea para alérgenos
  • determinação de IgE específica in vitro
Detalhes completos

Algoritmo de tratamento

AGUDA

sintomas leves ou intermitentes

sintomas persistentes e moderados a graves

CONTÍNUA

terapia habitual ineficaz ou pouco tolerada

Colaboradores

Autores

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

Disclosures

GCS has taken part in sponsored research for the ALK clinical trial of the house dust mite SLIT tablet for use in paediatric patients. He is a member of the Joint Task Force on Practice Parameters Workgroup on the Allergic Rhinitis Practice Parameter.

Acknowledgements

Dr Gary C. Steven would like to gratefully acknowledge Dr Alexander Greiner, a previous contributor to this topic.

Disclosures

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.

Peer reviewers

Mark Davis-Lorton, MD

Clinical Immunology Coordinator

Division of Rheumatology, Immunology and Allergy

Winthrop-University Hospital

Mineola

NY

Disclosures

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

Disclosures

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Dykewicz MS, Wallace DV, Amrol DJ, et al. Rhinitis 2020: a practice parameter update. J Allergy Clin Immunol. 2020 Oct;146(4):721-67.Full text  Abstract

Bousquet J, Schünemann HJ, Togias A, et al. Next-generation Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence. J Allergy Clin Immunol. 2020 Jan;145(1):70-80.e3.Full text  Abstract

Scadding GK, Kariyawasam HH, Scadding G, et al. BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (rev ed 2017). Clin Exp Allergy. 2017 Jul;47(7):856-89.Full text  Abstract

Wise SK, Lin SY, Toskala E, et al. International consensus statement on allergy and rhinology: allergic rhinitis. Int Forum Allergy Rhinol. 2018 Feb;8(2):108-352.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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