Background Rhinitis is defined as inflammation of the nasal membranes and is characterized by a symptom complex that consists of any combination of the following: sneezing, nasal congestion, nasal itching, and rhinorrhea. Allergic rhinitis is the most common cause of rhinitis.
Background Total cost $5.3 billion per year. (in America) Morbidity 10%-40% ( in China) Classification Perennial allergic rhinitis Seasonal allergic rhinitis (pollinosis)
Pathophysiology Allergic reaction is an exaggerated or inappropriate immune reaction and causes damage to the host Type I immediate hypersensitivity reaction mediated by IgE antibodies, which trigger the mast cells and basophils to release pharmacologically active agents.
CLINICAL History: Obtaining a detailed history is important in the evaluation of allergic rhinitis. Allergy history environmental exposures occupational exposures effects on quality of life Family history• Past medical history
Treatment (3) Immunotherapy Exact mechanism unknown Decrease allergen-specific IgE levels Increase allergen-specific IgG levels IgG molecules ( blocking antibodies that are important in impeding the allergic reaction. )
Treatment (3) Immunotherapymethod: increasing doses of injected allergen until the maximum tolerated dose is reachedmaintenance dose(maximum tolerated dose )course: 2 years or more
Treatment Surgical Care: Surgical care is not indicated for allergic rhinitis but may be indicated for comorbid or complicating conditions.
Patient Education Educate patients on environmental control measures, which involve both the avoidance of known allergens (substances to which the patient has IgE-mediated hypersensitivity) and the avoidance of nonspecific, or irritant, triggers
Question What are the major symptoms of allergic rhinitis? The main complications of allergic rhinitis are: The indication of the immunotherapy?(p60)