Keterangan
An allergic reaction to microscopic airborne particles known as allergens causes allergic rhinitis (hay fever). Histamine, a naturally occurring substance, is released by your body in response to inhaling allergens through your mouth or nose. Hay fever is brought on by numerous indoor and outdoor allergens. Dust mites, mould, pet dander, and plant and tree pollen are typical culprits. Sneezing, nasal congestion, and irritation of the mouth, nose, throat, and eyes are all signs of hay fever. Infectious rhinitis, also known as the common cold, is not the same as allergic rhinitis. Hay fever is not spread by others.
Ringkasan
- Rhinitis is defined by having two or more nasal symptoms, such as congestion, rhinorrhea, sneezing, itching, or impaired smell for more than one hour a day. It is categorized into infectious and non-infectious types, with non-infectious further divided into allergic and non-allergic rhinitis. Allergic rhinitis involves an immunological response primarily mediated by IGE, while non-allergic rhinitis lacks an identifiable cause.
- Allergic rhinitis is caused by inflammation of the nasal mucus due to an allergen, affecting 10-25% of the population. Etiology includes precipitating factors like allergens (dust, pollen, smoke) and predisposing factors (genetics, puberty, pregnancy). Allergens range widely, making allergy tests less useful than identifying individual triggers.
- The pathophysiology involves a type I hypersensitivity reaction mediated by immunoglobulin E, leading to vasodilation and increased capillary permeability, which increases mucus secretion. It's classified as intermittent (less than four days a week and four weeks a year) or persistent (more than four days a week and four weeks a year), and by severity (mild, moderate-severe) based on interference with daily activities.
- Complications can include allergic asthma, chronic otitis media, hearing loss, sinusitis, and orthodontic malocclusion in children. Common symptoms include sneezing, itchy nose, rhinorrhea, congestion, anosmia, headache, and red/swollen eyes. Physical examination may reveal a nasal crease, thin watery secretions, conjunctiva redness, and periorbital edema.
- Investigations typically involve checking a CBC to rule out infection, and allergy tests are generally discouraged due to their expense and limited scope. Prognosis is relatively good with treatment, focusing on avoiding exposure to allergens and medical management.
- Management includes medical treatment, avoiding exposure, and surgery. Antihistamines are the primary drugs of choice, but the overuse of decongestants like xylometazoline should be controlled due to the risk of atrophic rhinitis. Intranasal corticosteroids and mast cell stabilizers are also used, with immunotherapy reserved for severe cases.
- A practical approach to managing allergic rhinitis involves steam inhalation with xylometazoline, followed by intranasal steroids and antihistamines. Oral medications may include montelukast and levocetirizine. Surgical options, such as turbinoplasty and septoplasty, are limited and best left to ENT surgeons, as they do not address the underlying allergic cause.
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