Allergic rhinitis is an allergic inflammation of the nasal airways that occurs when an allergen triggers the production of IgE antibodies, causing symptoms like sneezing, nasal congestion, and itchy nose. It can affect quality of life by impacting work, school, and sleep. Persistent nasal blockage can lead to sinusitis. Complications include sinusitis, nasal polyps, and chronic otitis media. Diagnosis involves skin prick tests or measuring allergen-specific IgE in blood tests.

1. By- Dr. Armaan Singh

2. Allergic rhinitis is an allergic inflammation of the nasal airways. It
occurs when an allergen, such as pollen, dust, or animal dander
(particles of shed skin and hair) is inhaled by an individual with a
sensitized immune system. In such individuals, the allergen triggers the
production of the antibody immunoglobulin E (IgE), which binds to mast
cells andbasophils containing histamine. When caused by pollens of any
plants, it is called pollinosis, and, if specifically caused by grass
pollens, it is known as hay fever. While symptoms resembling a cold or
flu can be produced by an allergic reaction to pollen from plants and
grasses it does not cause a fever. The link with hay came about due to
an early (and incorrect) theory that the symptoms were brought about by
the smell of new hay (coumarin). A competing popular name was 'hay
asthma'.

3.  Sneezing.
 Rhinorrhea and nasal congestion:This may be either anterior or
posterior, leading to postnasal drip.
 Clear - infection unlikely.
 Unilateral - is uncommon.
 cerebrospinal fluid (CSF) leak should be excluded.Yellow-coloured
implies allergy or infection.
 Green-coloured is usually associated with infection. Blood-tinged
unilateral - tumour, foreign body or nose picking.
 Blood-tinged bilateral - bleeding points, nose picking or
granulomatous disorder.
 Itchy nose and/or palate.Symptoms tend to be bilateral, and worse
on waking.

4. A survey of adults found that about a third of allergic
rhinitis sufferers found that symptoms affected their
work, home life and social life.
In children, symptoms affected their schoolwork and
caused sleep problems.
Persistent blockage of intranasal passages
occasionally results in rhinosinusitis.
In adults, a strong association exists between nasal
polyps, asthma and sensitivity to aspirin - Samter's
triad.

5.  Non-allergic rhinitis. Infective rhinitis. Nasal polyps.
Rhinosinusitis. Adenoidal hypertrophy. Cystic fibrosis.
Kartagener's syndrome. Systemic lupus erythematosus and
granulomatous conditions, eg Wegener's
granulomatosis andsarcoidosis. Consider foreign bodies in
the young child.
 Other causes of nasal obstruction. Leaking of cerebrospinal
fluid will present with watery rhinorrhoea, often unilateral. It
is usually associated with trauma (including surgical trauma)
or neoplasia, but spontaneous leaking may occur. Nasal
neoplasms are rare; the diagnosis should be considered in
patients with unilateral symptoms of nasal obstruction, pain
or bleeding.

6. Complications- Sinusitis,Nasal
polyps,Chronic otitis media
Investigations- Skin prick test--When skin
prick tests are not available or the patient is
taking antihistamines or has dermatographism,
total and allergen-specific IgE concentrations in
the blood may be determined (radioallergosorbent
test (RAST)) or enzyme-linked immunosorbent
assay (ELISA).

7. Complications- Sinusitis,Nasal
polyps,Chronic otitis media
Investigations- Skin prick test--When skin
prick tests are not available or the patient is
taking antihistamines or has dermatographism,
total and allergen-specific IgE concentrations in
the blood may be determined (radioallergosorbent
test (RAST)) or enzyme-linked immunosorbent
assay (ELISA).