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Chapter 15: Allergic rhinitis.
Russell A Settipane1, Christina Schwindt
1Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. russell_settipane@brown.edu
American Journal of Rhinology & Allergy
|May 29, 2013
Summary
Allergic rhinitis impacts millions globally, affecting quality of life and productivity. Effective management involves environmental control, pharmacotherapy, and immunotherapy, with intranasal corticosteroids and antihistamines being key treatments.
Area of Science:
- Immunology
- Allergology
- Otolaryngology
Background:
- Allergic rhinitis affects 60 million in the U.S. and 1.4 billion worldwide, with increasing prevalence.
- Symptoms significantly impair quality of life, sleep, and productivity, and are linked to comorbidities like asthma and sinusitis.
- The condition involves a complex, allergen-driven mucosal inflammatory process mediated by immunoglobulin E (IgE).
Purpose of the Study:
- To review the diagnosis and management of allergic rhinitis.
- To highlight the impact of allergic rhinitis on patient well-being and associated health issues.
- To discuss current therapeutic strategies for allergic rhinitis.
Main Methods:
- Diagnosis relies on a thorough allergic history, physical examination, and specific IgE antibody assessment (skin testing or in vitro assays).
- Management strategies include environmental exposure modification, pharmacotherapy, and allergen-specific immunotherapy.
- Pharmacological treatments encompass intranasal options like antihistamines, corticosteroids, anticholinergic agents, mast cell stabilizers, saline, and decongestants.
Main Results:
- Intranasal corticosteroids and intranasal antihistamines are the most effective pharmacotherapies.
- Combination therapy (separate or fixed-dose) of intranasal corticosteroids and antihistamines is recommended for difficult-to-control cases.
- Treatment selection is guided by symptom severity and chronicity.
Conclusions:
- Allergic rhinitis is a prevalent condition with significant global health and economic impact.
- Comprehensive diagnosis and tailored management are crucial for improving patient outcomes.
- Current therapeutic options, particularly intranasal corticosteroids and antihistamines, offer effective symptom control.
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