Alergic Rhinitis

Allergic rhinitis is clinically defined as a symptomatic disorder of the nose induce by an IgE-mediated inflamation after allergen exposure of the membrane of the nose

The new classification of allergic rhinitis:

Uses symptoms and quality of life parameters

Is based on duration: intermitten or persistent

Is base on severity: mild or moderate-severe

Allergic Rhinitis

Seasonal allergic rhinitis/Hay fever : symptom complex that follows sensitization to windborne pollens of trees, grasses, and weeds.

Perennial allergic rhinitis : the patient has year-round symptoms, caused generally by allergens which exposed with the patient. Most often by indoor inhalant allergens.

Etiology

Weather changes

Food

Dust

House mite, tick

Pollution

Scent of alcohol

Chemical scent :ink, paint

Detergent powder

Pollen

Animal fur

Diagnosis / clinical manifestations

Paroxysmal sneezing

Rhinorrhea

Nasal obstrucion

Headache / lethargic

Itching of the nose, palate, pharynx, & ears

Itching, redness tearing of the eyes (conjunctive erythema)

Treatment

General :avoidance of exposure to suspected allergens/ irritants

Immunotheraphy (if cannot avoid the inhalant allergens)

Drug :

Antihistamines

Pseudoephedrine (nasal obstruction)

2-5 years : 15 mg / 6 hour

6-12 years : 30 mg / 6 hour

>12 years : 60 mg / 6 hour

Topical nasal corticosteroid (beclomethasone, budesonide, fluticasone, mometasone) for children with nasal symptoms are resistant to antihistamine-decongestant

Initial dosage : 1-2 spray in each nostril

(2-3 times) per day. After 3-4 days as symptoms improves, the dosa / frequency of use are reduced until a minimal effective dosage is reached.

Complications : local burning, irritation & epistaxis

 

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