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World Allergy Organization
WAO's mission: To be a global resource and advocate in the field of allergy, advancing excellence in clinical care through education, research and training as a world-wide alliance of allergy and clinical immunology societies.

Disease Summaries

Allergies in the Nose: Allergic Rhinitis

Definition of 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.

Classification of Rhinitis

Rhinitis is broken down into a number of different categories:

Infectious
  • Viral (e.g. common cold)
  • Bacterial (often following a common cold)
  • Fungal
Allergic
  • Intermittent (seasonal, e.g., hay fever)
  • Persistent (perennial – continuous symptoms)
Drug-Induced
  • Aspirin
  • Other medications
Occupational

Caused by allergy or sensitivity to airborne agents in the workplace:

  • Intermittent
  • Persistent
Hormonal

Related to puberty, pregnancy, menstrual cycle and some endocrine disorders

Other Causes/Types of Rhinitis
  • Foods
  • Irritants
  • Emotion
  • Gastroesophageal reflux
  • Atrophic rhinitis (shrunken nasal tissue)
  • NARES: Non-Allergic Rhinitis with Eosinophilia
Idiopathic

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: 

Intermittent

In which symptoms occur on less than 4 days a week or for less than 28 days at a time.

Persistent

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.

Epidemiology of Allergic Rhinitis

Children

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.

Adults

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.

 

Links to Additional Information on Allergic Rhinitis

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)
www.aaaai.org/public/fastfacts/rhinitis.stm

American College of Allergy, Asthma and Immunology (ACAAI)
www.acaai.org/allergist/allergies/Types/rhinitis/Pages/default.aspx

Australasian Society of Clinical Immunology and Allergy (ASCIA)
www.allergy.org.au/aer/infobulletins/what_is_hayfever.htm

Brazilian Society of Allergy and Immunopathology (in Portugese)
www.sbai.org.br/rinite.htm