it is an igE mediated immunologic response of nasal mucosa to air borne allergens

6. Older classification…….
-seasonal-.some seasons due
to pollen , flower…etc
-perennial-.can occur any time
in an year due to-dust mite,
smoke,..etc

7. AETIOLOGY
• GENETIC PREDISPOSITION
ONE PARENT HAVE—20%
BOTH PARENTS HAVE—47%
• ENVIRONMENT
SEASONAL - POLLENS FROM TREES
,GRASSES, & WEEDS
PERENNIAL - DUST MITES ,MOLDS,INSECT
PARTS ,FIBRES & ANIMAL DANDERS

8. Sensitization
Early phase reaction
Late phase reaction
Systemic reaction

25. Histamine- vasodialation ,
bronchospasm
Heparine-enhances
phagocytosis
ECF-A-attracts eosinophil
NCF-A-attracts neutrophil

30. Early phase reactions- 5 to 30
minuts

31. RELEASE OF MEDIATORS
INCREASEDVASCULAR HYPERACTIVITY SENSORY NERVE
CHANGE IN
SMOOTH
PERMEABILITY & OF GLANDS STIMULATION MUSCLE
TONE
VASODILATATION
TISSUE OEDEMA INCREASED SECRETION
NASAL BLOCKAGE RHINORRHOEA ITCHING &
BROCNCHOSPASM
SNEEZING

32. Late phase reaction- 6-
12hours
--- cellular inflammation
(recruitment of cells)
eosinophils, basophils,
monocytes,lymphocytes

33. SYSTEMIC ACTIVATION
• ANTIGEN STIMULATION IN THE NOSE OR
LUNG CAUSES THE RELEASE OF
EOSINOPHILS PRECURSORS FROM THE
BONE MARROW WHICH CIRCULATE TO
THE BOTH SITES

34. Sensitization
Early phase reaction
Late phase reaction
Systemic reaction

35. CLINICAL FEATURES
• SYMPTOMS
SEASONAL
PAROXYSMAL SNEEZING
WATERY NASAL DISCHARGE
NASAL OBSTRUCTION
ITCHING IN THE NOSE
ITCHING IN EYES PALATE OR PHARYNX
BRONCHOSPASM

36. • PERENNIAL
FREQUENT COLDS
PERSISTENTLY STUFFY NOSE
LOSS OF SENSE OF SMELL
POSTNASAL DRIP
CHRONIC COUGH
HEARING IMPAIRMENT

38. • SIGNS
NASAL SIGNS
-ALLERGIC SALUTE

39. • NASAL MUCOSA -PALE AND ODEMATOUS
- TURBINATES ARE SWOLLEN
- THIN WATERY OR MUCOID DISCHARGE

40. • OCULAR SIGNS
-OEDEMA OF LID
-COBBLESTONE APPEARANCE OF CONJUNCTIVA
-DARK CIRCLES UNDER THE EYES(ALLERGIC SHINERS)

41. • OTOLOGIC SIGNS
-RETRACTED TYMPANIC MEMBRANE
-SEROUS OTITIS MEDIA

42. • PHARYNGEAL SIGNS
-GRANULAR PHARYNGITIS
-FEATURES OF PROLONGED MOUTH BREATHING

43. • LARYNGEAL SIGNS
- HOARSENESS
- OEDEMA OF VOCAL CORDS

44. THANK U