IgE mediated Immunologic response of nasal mucosa Airborne Allergens Characterised by Watery nasal discharge Nasal obstructions Sneezing Itching in the nose Types and Aetiology of Allergic rhinitis Pathogenesis of allergic rhinitis Inhaled allergens -> Produce specific IgE antibody. Antibody become fixed to blood basophils and tissue mast cells. Antigen-antibody Reaction -> Degranulation -> Mediators release -> responsible for symptomatology

1. TOPIC : ALLERGIC
RHINITIS

3. Allergic Rhinitis
• IgE mediated Immunologic response of nasal mucosa
• Airborne Allergens
• Characterised by
• Watery nasal discharge
• Nasal obstructions
• Sneezing
• Itching in the nose

4. Allergic Rhinitis
Types
• Seasonal
• Perennial
Aetiology
• Inhalant allergens
• Genetic predisposition

5. Allergic Rhinitis
Pathogenesis
• Inhaled allergens -> Produce specific IgE
antibody. Antibody become fixed to blood
basophils and tissue mast cells.
• Antigen-antibody Reaction ->
Degranulation -> Mediators release ->
responsible for symptomatology

9. 1. Total and differential leukocyte count
• Peripheral eosinophilia may be seen
• But this is inconsistent finding

10. 2. Nasal Smear
• Nasal smear should be taken at the time of
clinically active disease.
• Shows large number of eosinophils in
allergic rhinitis.
• Nasal eosinophilia is also seen in certain
non allergic rhinitis with eosinophilia
syndrome

11. 3. Skin tests
A) Skin prick test
• Excellent method
• A positive reaction = CENTRAL WHEAL and
a surrounding ZONE OF ERYTHEMA
(FLARE)
• Within 10-15 min

12. 3) Skin tests
B) Specific IgE measurements
• In vitro test
• Good correlation between skin tests and
specific IgE measurements
• Result = false positive and false negative
may occur
• Recommended to correlate the two tests
with clinical symptoms

13. 4) Radioallergosorbent test (RAST)
• In vitro test
• Measures specific IgE antibody concentration
• In patient’s serum

14. 5) Nasal provocative test
• Crude method
• To challenge the nasal mucosa

15. TREATMENT

16. 1- Avoidance of allergen

17. 2- Treatment with drugs
• A) Antihistamines
• B) Sympathomimetic drugs (oral or topical)
• C) Corticosteroids
• D) Sodium cromoglycate
• E) Anticholinergics
• F) leukotriene receptor antagonists
• G) Anti-IgE

18. 3) Immunotherapy