Allergy
Definition: -
Hypersensitivity to allergens
(pollens, moulds), which
trigger allergic response is
called allergy
If nose is involved :
Nose
Allergic Rhinitis
Allergy
Immunology of the Upper Airway and Pathophysiology and Treatment of Allergic Rhinitis, Fuad M. Baroody Robert M. Naclerio, Chapter 40, 597-623
Immunological Mechanisms Underlying Allergic
Rhinitis
Allergic Rhinitis and Rhinosinusitis, Nadir Ahmad, Mark A. Zacharek, Otolaryngol Clin N Am41 (2008) 267281
Early Response to Antigen
Immunology of the Upper Airway and Pathophysiology and Treatment of Allergic Rhinitis, Fuad M. Baroody Robert M. Naclerio, Chapter 40, 597-623
Late Response To Antigen
Allergic Rhinitis and Rhinosinusitis, Nadir Ahmad, Mark A. Zacharek, Otolaryngol Clin N Am41 (2008) 267281
Pathogenesis Of
Allergic Rhinitis
And
Occurrence Of
Symptoms
Symptoms of Allergic Rhinitis
Recurrent episodes of
sneezing,
Pruritus, rhinorrhea,
Nasal congestion, and
lacrimation
Snorting throat clearing
Postnasal drip.
Nasal obstruction unilateral
or bilateral
Immunology of the Upper Airway and Pathophysiology and Treatment of Allergic Rhinitis, Fuad M. Baroody Robert M. Naclerio, Chapter 40, 597-623
Sequelae Of Allergic Rhinitis
Immunology of the Upper Airway and Pathophysiology and Treatment of Allergic Rhinitis, Fuad M. Baroody Robert M. Naclerio, Chapter 40, 597-623
Adenoid Facies
Classification Of Allergic Rhinitis
Immunology of the Upper Airway and Pathophysiology and Treatment of Allergic Rhinitis, Fuad M. Baroody Robert M. Naclerio, Chapter 40, 597-623
Classification Of Allergic Rhinitis
Immunology of the Upper Airway and Pathophysiology and Treatment of Allergic Rhinitis, Fuad M. Baroody Robert M. Naclerio, Chapter 40, 597-623
Severity Of Allergic rhinitis
Immunology of the Upper Airway and Pathophysiology and Treatment of Allergic Rhinitis, Fuad M. Baroody Robert M. Naclerio, Chapter 40, 597-623
Physical Examination
Nasal smear
Immunology of the Upper Airway and Pathophysiology and Treatment of Allergic Rhinitis, Fuad M. Baroody Robert M. Naclerio, Chapter 40, 597-623
Nasal Smears
Immunology of the Upper Airway and Pathophysiology and Treatment of Allergic Rhinitis, Fuad M. Baroody Robert M. Naclerio, Chapter 40, 597-623
Skin Testing
A comparison of skin endpoint titration and skin prick testing iA in the diagnosis of allergic n rhinitis. Rhinitis, Gungor, A et al, ENT Ear, Nose, and Throat Journal (Jan 2004); Vol 83:1, 54 54-60.
Multitest II
Whealing Response
A comparison of skin endpoint titration and skin prick testing iA in the diagnosis of allergic n rhinitis. Rhinitis, Gungor, A et al, ENT Ear, Nose, and Throat Journal (Jan 2004); Vol 83:1, 54 54-60.
Skin Testing : Disadvantages
Immunology of the Upper Airway and Pathophysiology and Treatment of Allergic Rhinitis, Fuad M. Baroody Robert M. Naclerio, Chapter 40, 597-623
IgE Levels
Immunology of the Upper Airway and Pathophysiology and Treatment of Allergic Rhinitis, Fuad M. Baroody Robert M. Naclerio, Chapter 40, 597-623
The Crux is..
Immunology of the Upper Airway and Pathophysiology and Treatment of Allergic Rhinitis, Fuad M. Baroody Robert M. Naclerio, Chapter 40, 597-623
Allergic Rhinitis And Quality Of Life
Increased daytime
sleepiness
Learning problems in
children
Work absenteeism
Reduction in work
productivity
Immunology of the Upper Airway and Pathophysiology and Treatment of Allergic Rhinitis
Fuad M. Baroody, Robert M. Naclerio
Prevention is better than cure: Avoidance Of
Allergens
It is potentially an effective treatment
Immunology of the Upper Airway and Pathophysiology and Treatment of Allergic Rhinitis, Fuad M. Baroody Robert M. Naclerio, Chapter 40, 597-623
Pharmacotherapy
Nasal
Drug type Itch / sneezing Discharge Blockage Impaired smell
preparations
Antihistamines +++ ++ + _
AZELASTINE
Xylometazoline
Decongestants _ + +++ _
Oxymetazoline
Fluticasone
Topical
Mometasone
Corticosteroids +++ +++ ++ +
Allergic Rhinitis & its Impact on Asthma (ARIA)
Guidelines
Management of Intermittent AR
Avoid Allergens
Decongestants Decongestants/LTRA/Chromone
LTRA
Fluticasone - 2 sprays/nostril OD
LTRA= Leukotriene Receptor Antagonists Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 Revision ,Broz ek et al
J allergy clin immunol Volume 126, number 3
Allergic Rhinitis & its Impact on Asthma (ARIA)
Guidelines
Management of Persistent AR
Avoid Allergens
Nasal H1 blocker
Oral H1 blocker / LTRA
Decongestants / Chromone
Intranasal CS / Mometasone/ /Fluticasone
**Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 Revision , *Allergic Rhinitis Current Pharmacotherapy ,John H. Krouse, Otolaryngol Clin N Am 41 (2008) 347358
Broz ek et al J allergy clin immunol Volume 126, number 3
Montelukast
Allergic Rhinitis Current Pharmacotherapy ,John H. Krouse, Otolaryngol Clin N Am 41 (2008) 347358
ARAI-2010 Use Of Newer Antihistaminics
Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 Revision ,Broz ek et al J allergy clin immunol Volume 126, number 3
Fexofenadine
Allergic Rhinitis Current Pharmacotherapy ,John H. Krouse, Otolaryngol Clin N Am 41 (2008) 347358
Summary