Allergic Rhinitis , also known as hay fever , is a type of nasal inflammation that occurs when the immune system overreacts to airborne allergens. Signs and symptoms include a runny or stuffy nose, sneezing, red, itching, and watery eyes, and swelling around the eyes. The fluid from the nose is usually obvious. Symptoms of onset often within minutes of exposure and they can affect sleep, ability to work, and the ability to concentrate in school. Those with symptoms of pollen usually develop symptoms for a certain time of the year. Many people with allergic rhinitis also suffer from asthma, allergic conjunctivitis, or atopic dermatitis.
Allergic rhinitis is usually triggered by environmental allergens such as pollen, pet dander, dust, or fungi. Inherited genetics and environmental exposure contribute to the development of allergies. Growing up on the farm and having many siblings reduces risk. The underlying mechanism involves IgE antibodies attached to the allergen and causes the release of inflammatory chemicals such as histamine from mast cells. The diagnosis is usually based on a medical history combined with a skin prick test or a blood test for specific IgE antibodies of the allergen. However, these tests are sometimes false. Allergy symptoms are similar to ordinary flu symptoms; However, they often last for more than two weeks and usually do not include fever.
Exposure to animals early in life can reduce the risk of developing allergies in them later. A number of drugs can improve symptoms including nasal steroids, antihistamines such as diphenhydramine, sodium chromosine, and leukotriene receptor antagonists such as montelukast. Drugs, however, are not enough or related to side effects in many people. Exposing people to a larger and larger number of allergens, known as allergen immunotherapy, is often effective. Allergens can be given as an injection just under the skin or as a tablet under the tongue. Treatment usually lasts for three to five years after the benefits can be extended.
Allergic rhinitis is a type of allergy that affects the greatest number of people. In Western countries, between 10-30% of people are affected in a given year. This most often occurs between the ages of twenty and forty years. The first accurate description is from a 10th-century Rhazes doctor. Pollen was identified as the cause in 1859 by Charles Blackley. In 1906, the mechanism was determined by Clemens von Pirquet. The association with straw occurs because of an early (and incorrect) theory that the symptoms are brought on by the smell of new straw.
Video Allergic rhinitis
Signs and symptoms
The typical symptoms of allergic rhinitis are: rhinorrhea (excess nasal secretion), itching, sneezing, and stuffy nose and obstruction. Typical physical findings include swelling of the conjunctiva and erythema, eyelid swelling, venous stasis of the lower eyelid (under eye ring known as "allergic shiners"), swollen nose turbinates, and middle ear effusion.
There can also be signs of behavior; to relieve irritation or mucus flow, people may wipe or rub their nose with their palms in an upward motion: an act known as "nose salute" or "allergic respect". This may cause a nasal crease (or above each nostril if only one side of the nose is wiped at a time), commonly referred to as a "transverse nose fold", and may cause permanent physical deformity if repeated enough..
One might also find that cross-reactivity occurs. For example, a person allergic to birch pollen may also find that he has an allergic reaction to apple or potato skins. A clear sign of this is the occurrence of an itchy throat after eating an apple or sneeze when peeling potatoes or apples. This happens because of the similarity in protein pollen and food. There are many cross-reacting substances. Hay fever is not a true fever, which means it does not cause the core body temperature in fever over 37.5-38.3 Ã, Â ° C (99.5-100,9Ã, Â ° F).
Maps Allergic rhinitis
Cause
Allergic rhinitis triggered by seasonal pollen of certain seasonal crops is commonly known as "hay fever", as it is most common during dry grass season. However, it is possible to have allergic rhinitis throughout the year. The pollen that causes fever varies between individuals and from region to region; In general, pollen pollen plants are small and almost invisible is the main cause. Pollen insect pollinating plants are too large to stay in the air and pose no risk. Examples of plants that are generally responsible for hay fever include:
- Tree: like pine (
), birch ( Betula ), alder ( Alnus ), cedar ( Cedrus , hazel ( Corylus ), hornbeam ( Carpinus ), horse chestnut ( Aesculus ), willow ( Salix ), poplar ( Populus ), plane ( Platanus ), linden/lime ( Tilia ), and olive ( Olea ). In the northern latitudes, birch is considered the most common pollen of allergenic trees, with an estimated 15-20% of people with hay fever sensitive to birch pollen. The main antigen in this is a protein called Bet V I. The most dominant olive juice in the Mediterranean region. Hay fever in Japan is mainly caused by sugi ( Cryptomeria japonica ) and hinoki ( Chamaecyparis obtusa ) pollen trees. - The "allergic-friendly" tree includes: ash (women only), red maple, yellow poplar, dogwood, magnolia, double flowered cherry, fir, cypress, and flowering plum.
- Grasses (Family Poaceae): mainly ryegrass ( Lolium sp.) and timothy ( Phleum pratense ). An estimated 90% of people with hay fever are allergic to grass pollen.
- Weeds: ragweed ( Ambrosia ), plantain ( Plantago ), nettle/parietaria (Urticaceae), mugwort ( Artemisia Vulgaris ), Fat hen ( Chenopodium ), and sorrel/dock ( Rumex )
Allergic rhinitis can also be caused by an allergy to Peruvian Balsam, which is in various fragrances and other products.
Diagnosis
Allergy tests may reveal sensitive specific allergens in individuals. Skin testing is the most common allergy testing method. This may include a stick test to determine whether a particular substance causes rhinitis, or intradermal, scratches, or other tests. Less commonly, suspected allergens are dissolved and fall to the lower eyelid as a testing tool for allergies. This test should be performed only by the doctor, as this can be dangerous if done improperly. In some individuals unable to undergo a skin test (as determined by a doctor), a RAST blood test may be helpful in determining the sensitivity of a particular allergen. Peripheral eosinophilia can be seen in the number of differential leukocytes.
Allergy tests may indicate an allergy that does not actually cause symptoms or allergy-causing symptoms. Intradermal allergic tests are more sensitive than skin prick tests but are more often positive in people who do not have symptoms of the allergen.
Even if someone has skin-prick, intradermal, and negative blood tests for allergies, he may still have allergic rhinitis, from a local allergy in the nose. This is called local allergic rhinitis. Special tests are required to diagnose local allergic rhinitis.
Classification
Allergic rhinitis can be seasonal or lasting. Seasonal allergic rhinitis occurs especially during the pollen season. It usually does not develop until after 6 years of age. Allergic rhinitis occurs year-round. This type of allergic rhinitis is often seen in younger children.
Allergic rhinitis can also be classified as Mild-Intermittent, Moderate-Severe intermittent, Mild-Persistent, and Moderate-Severe Persistent. Intermittent is when symptoms appear & lt; 4 days per week or & lt; 4 weeks in a row. Keep going is when the symptoms show up & gt; 4 days/week and & gt; 4 weeks in a row. The symptoms are considered mild with normal sleep, no interruption of daily activities, no interruption of work or school, and if symptoms are not troublesome. Severe symptoms cause sleep disturbance, disruption of daily activities, and school or occupational disorders.
Allergic Rhinitis locally
Allergic Rhinitis is an allergic reaction in the nose to allergens, without systemic allergies. So skin-pricks and blood tests for allergies are negative, but there are IgE antibodies produced in the nose that react to certain allergens. The intradermal skin test may also be negative.
The symptoms of local allergic rhinitis are similar to those of allergic rhinitis, including the symptoms in the eye. Just like allergic rhinitis, people may experience seasonal or annual seasonal allergic rhinitis. The symptoms of local allergic rhinitis can be mild, moderate, or severe. Local allergy rhinitis is associated with conjunctivitis and asthma.
In one study, about 25% of people with rhinitis had local allergic rhinitis. In some studies, more than 40% of people diagnosed with nonalergial rhinitis are found to actually have local allergic rhinitis. Steroid nasal sprays and oral antihistamines have been found to be effective for local allergic rhinitis.
Prevention
One way to prevent allergic rhinitis is to use a respirator or mask when it is close to a potential allergen.
Growing on farming and having many older brothers and sisters reduces risk.
Treatment
The goal of rhinitis treatment is to prevent or reduce symptoms caused by inflammation of the affected tissue. Effective measures include avoiding allergens. Intranasal corticosteroids are the preferred medical treatment for persistent symptoms, with other options if these are not effective. Second-line therapy includes antihistamines, decongestants, chromolines, leukotriene receptor antagonists, and nasal irrigation. Antihistamines by mouth are suitable for occasional use with mild intermittent symptoms. Waterproof coverings, air filters, and restraint of certain foods in childhood have no evidence to support their effectiveness.
Antihistamines
Antihistamines can be taken orally and nose to control symptoms such as sneezing, rhinorrhea, itching, and conjunctivitis.
We recommend taking oral antihistamine before exposure, especially for seasonal allergic rhinitis. In cases of nasal antihistamines such as nasal antihistamine azelastine spray, relief from symptoms experienced within 15 minutes allows for a more direct 'appropriate' approach to dosage. There is not enough evidence of the efficacy of antihistamines as adjunctive therapy with nasal steroids in the management of intermittent or persistent allergic rhinitis in children, so adverse effects and additional costs should be considered.
Antihistamines (such as azelastine in the form of eye drops and ketotifen) are used for conjunctivitis, while intranasal forms are used primarily for sneezing, rhinorrhea, and nasal pruritus.
Antihistamines can have undesirable side effects, the most important is drowsiness in the case of oral antihistamine tablets. First-generation antihistamines such as diphenhydramine cause drowsiness, but second- and third-generation antihistamines such as cetirizine and loratadine are less likely to cause this problem.
Pseudoephedrine is also indicated for vasomotor rhinitis. It is used only when nasal congestion is present and can be used with antihistamines. In the United States, oral decongestants containing pseudoephedrine should be purchased behind the pharmaceutical table by law in an attempt to prevent the manufacture of methamphetamine.
Steroids
Intranasal corticosteroids are used to control symptoms associated with sneezing, rhinorrhea, itching, and nasal congestion. Nasal spray steroids are effective and safe, and may be effective without oral antihistamines. They take several days to act and must be taken continuously for several weeks, as their therapeutic effects increase with time.
In 2013, a study compared the efficacy of nasal spray of mometasone furoate to oral betamethasone tablets for the treatment of people with seasonal allergic rhinitis and found that both had similar effects on nasal symptoms in humans.
Systemic steroids such as prednisone and intramuscular tablets of triamcinolone acetonide or glucocorticoids (such as betamethasone) are effective injections to reduce inflammation of the nose, but their use is limited by the short duration of effects and side effects of prolonged steroid therapy.
More
Other measures that can be used on the second line include: decongestants, chromolins, leukotriene receptor antagonists, and nonpharmacological therapies such as nasal irrigation.
Topical decongestants can also help relieve symptoms such as nasal congestion, but should not be used for long periods, because stopping them after prolonged use can lead to a soaring nasal congestion called rhinitis medicamentosa.
For nocturnal symptoms, intranasal corticosteroids can be combined with nighttime oxymetazoline, adrenergic alpha-agonist, or antihistamine nasal spray without risk of medicamentous rhinitis.
Immunotherapy Allergy
Allergen immunotherapy therapy (AIT, also called desensitization) involves administering doses of allergens to familiarize the body with generally harmless substances (pollen, house dust mites), thus triggering certain long-term tolerances. Allergy immunotherapy may be given orally (as sublingual tablets or sublingual drops), or by subcutaneous injection.
Alternative medicine
Therapeutic efficacy of alternative treatments such as acupuncture and homeopathy are not supported by available evidence. Some evidence suggests that acupuncture is effective for rhinitis, while other evidence is not. However, the overall quality of the evidence is very bad.
Epidemiology
Allergic rhinitis is a type of allergy that affects the greatest number of people. In Western countries, between 10 and 30 percent of people are affected in a given year. This most often occurs between the ages of twenty and forty years.
History
The first accurate description is from a 10th-century Rhazes doctor. Pollen was identified as the cause in 1859 by Charles Blackley. In 1906 the mechanism was determined by Clemens von Pirquet. The association with straw occurs because of an early (and incorrect) theory that the symptoms are brought on by the smell of new straw.
References
External links
- Allergic rhinitis in Curlie (based on DMOZ)
- Ã, "Hay fever". Encyclopedia Americana . 1920.
Source of the article : Wikipedia
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