Allergies in the Nose: Allergic Rhinitis
A symptomatic disorder of the nose resulting from an IgE-mediated immunological reaction following exposure to allergen.
The major symptoms are runny nose (rhinorrhea), nasal itching, obstruction and sneezing which are reversible either spontaneously or with treatment.
Rhinitis is broken down into a number of different categories:
- Viral (e.g. common cold)
- Bacterial (often following a common cold)
- Intermittent (seasonal, e.g., hay fever)
- Persistent (perennial – continuous symptoms)
- Other medications
Caused by allergy or sensitivity to airborne agents in the workplace:
Related to puberty, pregnancy, menstrual cycle and some endocrine disorders
Other Causes/Types of Rhinitis
- Gastroesophageal reflux
- Atrophic rhinitis (shrunken nasal tissue)
- NARES: Non-Allergic Rhinitis with Eosinophilia
Cause not known
The traditional classification is seasonal and perennial, but in reality the situation is not as clearly defined. Allergens that are seasonal in one part of the world can be perennial in other areas. Typically, patients are allergic to more than one allergen.
A better classification is:
In which symptoms occur on less than 4 days a week or for less than 28 days at a time.
In which symptoms occur on the majority of days of the week and for more than 28 days.
The Severity of Allergic Rhinitis
In mild rhinitis there is no disturbance in sleep, leisure, school or work activities.
In moderate/severe rhinitis there is disturbance to sleep, leisure, school or work activities.
The prevalence of rhinitis symptoms in the International Study on Asthma and Allergies in Childhood (ISAAC) varied between 0.8% and 14.9% in 6-7 year olds and between 1.4% and 39.7% in 13-14 year olds. Countries with a very low prevalence include Indonesia, Albania, Romania, Georgia and Greece. Countries with a very high prevalence include Australia, New Zealand and the United Kingdom.
There is no equivalent to ISAAC for adults. National surveys show prevalence rates of rhinitis of between 5.9% (France) and 29% (United Kingdom) with a mean of 16%. Perennial (persistent) rhinitis is probably more common in adults than in children.
Allergy Society of South Africa (ALLSA)
www.allergysa.org. Go to online literature, then to hayfever, then to allergic rhinitis
American Academy of Allergy, Asthma and Immunology (AAAAI)
American College of Allergy, Asthma and Immunology (ACAAI)
Australasian Society of Clinical Immunology and Allergy (ASCIA)
Brazilian Society of Allergy and Immunopathology (in Portugese)