Rhinitis causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]

Overview

Causes

Common Causes

  • Allergic rhinitis- This is the most common cause of chronic rhinitis.[1] The common triggers are listed in the table below.
  • Infectious rhinitis- 98% of acute infectious rhinitis are due to viral upper respiratory infections.[2] Common viruses implicated are
  • Vasomotor rhinitis- This is the most common type of nonallergic rhinitis in the adult population. The causes of vasomotor rhinitis are listed below.
Class Causes of Rhinitis[3][4][5][6]
Allergic rhinitis Indoor and outdoor airborne substances such as:
  • Pollens
  • Molds
  • Dust mite fetal particles
  • Coakroach residues
  • Animal danders
Nonallergic rhinitis Vasomotor rhinitis
  • Irritant triggered- Strong odors from chemicals like chlorine, cooking smells, flowers, perfumes, environmental tobacco smoke and pollutants
  • Cold air/Dry air
  • Exercise
  • Emotional
  • Trauma[7]
  • Undetermined or poorly defined triggers
Gustatory rhinitis- Triggered by solid/liquid food ingestion such as
  • Hot food
  • Spicy food
  • Alcohol
Infectious
  • Viruses
  • Bacteria
  • Fungi
  • Parasites
Occupational rhinitis Caused by protein and chemical allergens, chemical respiratory sensitizers, or unknown mechanisms
  • Noxious fumes/vapors/smoke/dust- Pesticides, chromium vapors, volatile organic compounds, tthermal degradation products of polyurethanes, grain and cotton dust, chlorine, formaldehyde, ammonia, wood dust, waste handling, solder fumes, detergent powder
Other rhinitis syndrome Hormonally induced
  • Gestational/Pregnancy-induced
  • Menstrual cycle related
Drug-induced[8]
  • Rhinitis medicamentosa
  1. Nasal decongestant sprays- Sympathomimetics(Amphetamine, Benzedrine, Ephedrine, Phenylephrine, Phenylpropanolamine), Imidazolines(Naphazoline, Oxymetazoline, Xylometazoline)
  2. Intranasal cocaine and methamphetamine
  • Oral contraceptives and Exogenous estrogens
  • Antihypertensives and cardiovascular agents- ACE inhibitors, Beta blockers(oral and intraocular), Calcium channel blockers, Thiazides diuretics, centrally acting sympatholytics(clonidine, guanfacine, methyldopa, moxonidine, reserpine), peripherally acting sympatholytics(prazosin, guanethidine,indoramin, doxazosin, phentolamine), Hydralazine.
  • Aspirin/NSAIDs
  • Other medications such as phosphodiesterase-5 selective inhibitors(sildenafil, tadalafil, vardenafil), Gabapentin, some antipsychotic medications(chlordiazepoxide, chlorpromazine, risperidone, thioridazine)
Primary atrophic rhinitis- causes include:
  • Infection with organisms such as Klebsiella ozaenae
  • Turbulent air flow
  • Climate factors
  • Racial factors

Secondary atrophic rhinitis- causes include:

  • Extensive surgery
  • Granulomatous diseases
  • Direct trauma
  • Radiotherapy
Rhinitis associated with inflammatory-immunologic disorders


Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Butorphanol, Cefpodoxime, Desmopressin, Dimercaprol, Dornase Alfa, Flunisolide, Flurbiprofen, Ivacaftor, Moxifloxacin ophthalmic, Nilutamide, Rifaximin, Rimexolone, Sertraline, Tamsulosin, trichophyton mentagrophytes and trichophyton rubrum, Thalidomide, Tizanidine, Topiramate
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

References

  1. Dykewicz MS, Hamilos DL (2010). "Rhinitis and sinusitis". J Allergy Clin Immunol. 125 (2 Suppl 2): S103–15. doi:10.1016/j.jaci.2009.12.989. PMID 20176255  20176255 Check |pmid= value (help).
  2. Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA; et al. (2008). "The diagnosis and management of rhinitis: an updated practice parameter". J Allergy Clin Immunol. 122 (2 Suppl): S1–84. doi:10.1016/j.jaci.2008.06.003. PMID 18662584.
  3. Kaliner MA (2011). "Nonallergic rhinopathy (formerly known as vasomotor rhinitis)". Immunol Allergy Clin North Am. 31 (3): 441–55. doi:10.1016/j.iac.2011.05.007. PMID 21737036.
  4. Romeo, Jonathan; Dykewicz, Mark (2014). "Chapter 9:Differential Diagnosis of Rhinitis and Rhinosinusitis". Diseases of the Sinuses. Springer New York. pp. 133–152. ISBN 978-1-4939-0265-1.
  5. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A; et al. (2008). "Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen)". Allergy. 63 Suppl 86: 8–160. doi:10.1111/j.1398-9995.2007.01620.x. PMID 18331513.
  6. Segal S, Shlamkovitch N, Eviatar E, Berenholz L, Sarfaty S, Kessler A (1999). "Vasomotor rhinitis following trauma to the nose". Ann Otol Rhinol Laryngol. 108 (2): 208–10. PMID 10030243.
  7. Varghese M, Glaum MC, Lockey RF (2010). "Drug-induced rhinitis". Clin Exp Allergy. 40 (3): 381–4. doi:10.1111/j.1365-2222.2009.03450.x. PMID 20210811.

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