Rhinitis natural history, complications and prognosis: Difference between revisions
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{{CMG}} {{AE}} {{FB}} | {{CMG}} {{AE}} {{FB}} | ||
==Overview== | ==Overview== | ||
Rhinitis is a heterogeneous group of disorders that can significantly impact the quality of life of the affected individual<ref name="Diseases of the Sinuses">{{cite book |last1=Romeo |first1=Jonathan |last2=Dykewicz |first2=Mark |title=Diseases of the Sinuses |publisher=Springer New York |date=2014 |pages=133-152 |chapter=Chapter 9:Differential Diagnosis of Rhinitis and Rhinosinusitis |isbn=978-1-4939-0265-1}}</ref> A heightened awareness of the condition and its potential debilitating comorbidities/complications is essential for a timely intervention.<ref name="Diseases of the Sinuses">{{cite book |last1=Romeo |first1=Jonathan |last2=Dykewicz |first2=Mark |title=Diseases of the Sinuses |publisher=Springer New York |date=2014 |pages=133-152 |chapter=Chapter 9:Differential Diagnosis of Rhinitis and Rhinosinusitis |isbn=978-1-4939-0265-1}}</ref><ref name="pmid11449200">{{cite journal| author=Skoner DP| title=Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. | journal=J Allergy Clin Immunol | year= 2001 | volume= 108 | issue= 1 Suppl | pages= S2-8 | pmid=11449200 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11449200 }} </ref> | |||
==Natural History, Complications, Prognosis== | ==Natural History, Complications, Prognosis== | ||
===Natural | ===Natural History=== | ||
Rhinitis is a very common disease, and it is sometimes erroneously viewed as a trivial disease.<ref name="pmid18662584">{{cite journal| author=Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al.| title=The diagnosis and management of rhinitis: an updated practice parameter. | journal=J Allergy Clin Immunol | year= 2008 | volume= 122 | issue= 2 Suppl | pages= S1-84 | pmid=18662584 | doi=10.1016/j.jaci.2008.06.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18662584 }} </ref><ref name="Diseases of the Sinuses">{{cite book |last1=Romeo |first1=Jonathan |last2=Dykewicz |first2=Mark |title=Diseases of the Sinuses |publisher=Springer New York |date=2014 |pages=133-152 |chapter=Chapter 9:Differential Diagnosis of Rhinitis and Rhinosinusitis |isbn=978-1-4939-0265-1}}</ref> Allergic rhinitis rarely occurs in isolation, it is a product of a genetic predisposition, epigenetic events, and environmental exposures, and it is frequently associated with other forms of atopy such as eczema, asthma, and allergic eye disease(allergic rhinoconjunctivitis).<ref name="pmid27490123">{{cite journal| author=Shaker M, Salcone E| title=An update on ocular allergy. | journal=Curr Opin Allergy Clin Immunol | year= 2016 | volume= 16 | issue= 5 | pages= 505-10 | pmid=27490123 | doi=10.1097/ACI.0000000000000299 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27490123 }} </ref><ref name="pmid16634358">{{cite journal| author=Sacre Hazouri JA| title=[Allergic rhinitis. Coexistent diseases and complications. A review and analysis]. | journal=Rev Alerg Mex | year= 2006 | volume= 53 | issue= 1 | pages= 9-29 | pmid=16634358 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16634358 }} </ref><ref name="pmid25182349">{{cite journal| author=Mims JW| title=Epidemiology of allergic rhinitis. | journal=Int Forum Allergy Rhinol | year= 2014 | volume= 4 Suppl 2 | issue= | pages= S18-20 | pmid=25182349 | doi=10.1002/alr.21385 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25182349 }} </ref> The vast majority of individuals with asthma have rhinitis, and allergic eye disease has been reported to affect almost all patients with allergic rhinitis.<ref name="pmid27490123">{{cite journal| author=Shaker M, Salcone E| title=An update on ocular allergy. | journal=Curr Opin Allergy Clin Immunol | year= 2016 | volume= 16 | issue= 5 | pages= 505-10 | pmid=27490123 | doi=10.1097/ACI.0000000000000299 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27490123 }} </ref><ref name="pmid18331513">{{cite journal| author=Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A et al.| title=Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). | journal=Allergy | year= 2008 | volume= 63 Suppl 86 | issue= | pages= 8-160 | pmid=18331513 | doi=10.1111/j.1398-9995.2007.01620.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18331513 }} </ref> Nonallergic rhinitis is also associated with asthma.<ref name="pmid22056609">{{cite journal| author=Westman M, Stjärne P, Asarnoj A, Kull I, van Hage M, Wickman M et al.| title=Natural course and comorbidities of allergic and nonallergic rhinitis in children. | journal=J Allergy Clin Immunol | year= 2012 | volume= 129 | issue= 2 | pages= 403-8 | pmid=22056609 | doi=10.1016/j.jaci.2011.09.036 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22056609 }} </ref><ref name="pmid18331513">{{cite journal| author=Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A et al.| title=Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). | journal=Allergy | year= 2008 | volume= 63 Suppl 86 | issue= | pages= 8-160 | pmid=18331513 | doi=10.1111/j.1398-9995.2007.01620.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18331513 }} </ref> Frequent extension of rhinitis | Rhinitis is a very common disease, and it is sometimes erroneously viewed as a trivial disease.<ref name="pmid18662584">{{cite journal| author=Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al.| title=The diagnosis and management of rhinitis: an updated practice parameter. | journal=J Allergy Clin Immunol | year= 2008 | volume= 122 | issue= 2 Suppl | pages= S1-84 | pmid=18662584 | doi=10.1016/j.jaci.2008.06.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18662584 }} </ref><ref name="Diseases of the Sinuses">{{cite book |last1=Romeo |first1=Jonathan |last2=Dykewicz |first2=Mark |title=Diseases of the Sinuses |publisher=Springer New York |date=2014 |pages=133-152 |chapter=Chapter 9:Differential Diagnosis of Rhinitis and Rhinosinusitis |isbn=978-1-4939-0265-1}}</ref> Allergic rhinitis rarely occurs in isolation, it is a product of a genetic predisposition, epigenetic events, and environmental exposures, and it is frequently associated with other forms of [[atopy]] such as [[eczema]], [[asthma]], and allergic eye disease(allergic rhinoconjunctivitis).<ref name="pmid27490123">{{cite journal| author=Shaker M, Salcone E| title=An update on ocular allergy. | journal=Curr Opin Allergy Clin Immunol | year= 2016 | volume= 16 | issue= 5 | pages= 505-10 | pmid=27490123 | doi=10.1097/ACI.0000000000000299 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27490123 }} </ref><ref name="pmid16634358">{{cite journal| author=Sacre Hazouri JA| title=[Allergic rhinitis. Coexistent diseases and complications. A review and analysis]. | journal=Rev Alerg Mex | year= 2006 | volume= 53 | issue= 1 | pages= 9-29 | pmid=16634358 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16634358 }} </ref><ref name="pmid25182349">{{cite journal| author=Mims JW| title=Epidemiology of allergic rhinitis. | journal=Int Forum Allergy Rhinol | year= 2014 | volume= 4 Suppl 2 | issue= | pages= S18-20 | pmid=25182349 | doi=10.1002/alr.21385 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25182349 }} </ref> The vast majority of individuals with asthma have rhinitis, and allergic eye disease has been reported to affect almost all patients with allergic rhinitis.<ref name="pmid27490123">{{cite journal| author=Shaker M, Salcone E| title=An update on ocular allergy. | journal=Curr Opin Allergy Clin Immunol | year= 2016 | volume= 16 | issue= 5 | pages= 505-10 | pmid=27490123 | doi=10.1097/ACI.0000000000000299 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27490123 }} </ref><ref name="pmid18331513">{{cite journal| author=Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A et al.| title=Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). | journal=Allergy | year= 2008 | volume= 63 Suppl 86 | issue= | pages= 8-160 | pmid=18331513 | doi=10.1111/j.1398-9995.2007.01620.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18331513 }} </ref> Nonallergic rhinitis is also associated with asthma.<ref name="pmid22056609">{{cite journal| author=Westman M, Stjärne P, Asarnoj A, Kull I, van Hage M, Wickman M et al.| title=Natural course and comorbidities of allergic and nonallergic rhinitis in children. | journal=J Allergy Clin Immunol | year= 2012 | volume= 129 | issue= 2 | pages= 403-8 | pmid=22056609 | doi=10.1016/j.jaci.2011.09.036 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22056609 }} </ref><ref name="pmid18331513">{{cite journal| author=Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A et al.| title=Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). | journal=Allergy | year= 2008 | volume= 63 Suppl 86 | issue= | pages= 8-160 | pmid=18331513 | doi=10.1111/j.1398-9995.2007.01620.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18331513 }} </ref> Frequent extension of rhinitis into the sinuses also occur, resulting in [[rhinosinusitis]].<ref name="pmid20176255">{{cite journal| author=Dykewicz MS, Hamilos DL| title=Rhinitis and sinusitis. | journal=J Allergy Clin Immunol | year= 2010 | volume= 125 | issue= 2 Suppl 2 | pages= S103-15 | pmid=20176255 | doi=10.1016/j.jaci.2009.12.989 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20176255 }} </ref><ref name= "Diseases of the Sinuses"></ref> Children with nonallergic rhinitis have a higher likelihood of undergoing remission, compared with those with allergic rhinitis, who tend to have a more persistent disease.<ref name="pmid22056609">{{cite journal| author=Westman M, Stjärne P, Asarnoj A, Kull I, van Hage M, Wickman M et al.| title=Natural course and comorbidities of allergic and nonallergic rhinitis in children. | journal=J Allergy Clin Immunol | year= 2012 | volume= 129 | issue= 2 | pages= 403-8 | pmid=22056609 | doi=10.1016/j.jaci.2011.09.036 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22056609 }} </ref> Remission occurs in up to 73% of four year old children with nonallergic rhinitis by the age of eight years.<ref name="pmid22056609">{{cite journal| author=Westman M, Stjärne P, Asarnoj A, Kull I, van Hage M, Wickman M et al.| title=Natural course and comorbidities of allergic and nonallergic rhinitis in children. | journal=J Allergy Clin Immunol | year= 2012 | volume= 129 | issue= 2 | pages= 403-8 | pmid=22056609 | doi=10.1016/j.jaci.2011.09.036 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22056609 }} </ref> Rhinitis is a significant cause of lost school and work days, and it constitutes a huge financial burden to the society.<ref name="pmid15025839">{{cite journal| author=Schoenwetter WF, Dupclay L, Appajosyula S, Botteman MF, Pashos CL| title=Economic impact and quality-of-life burden of allergic rhinitis. | journal=Curr Med Res Opin | year= 2004 | volume= 20 | issue= 3 | pages= 305-17 | pmid=15025839 | doi=10.1185/030079903125003053 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15025839 }} </ref><ref name="pmid18662584">{{cite journal| author=Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al.| title=The diagnosis and management of rhinitis: an updated practice parameter. | journal=J Allergy Clin Immunol | year= 2008 | volume= 122 | issue= 2 Suppl | pages= S1-84 | pmid=18662584 | doi=10.1016/j.jaci.2008.06.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18662584 }} </ref> Untreated/poorly treated chronic rhinitis is associated with a diminished quality of life, disordered sleep, impaired work performance, and several other co-morbidities.<ref name="Diseases of the Sinuses"></ref><ref name="pmid16634358">{{cite journal| author=Sacre Hazouri JA| title=[Allergic rhinitis. Coexistent diseases and complications. A review and analysis]. | journal=Rev Alerg Mex | year= 2006 | volume= 53 | issue= 1 | pages= 9-29 | pmid=16634358 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16634358 }} </ref> | ||
=== | ===Complications=== | ||
The complications of rhinitis include the following:<ref name="pmid18331513">{{cite journal| author=Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A et al.| title=Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). | journal=Allergy | year= 2008 | volume= 63 Suppl 86 | issue= | pages= 8-160 | pmid=18331513 | doi=10.1111/j.1398-9995.2007.01620.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18331513 }} </ref><ref name="pmid18662584">{{cite journal| author=Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al.| title=The diagnosis and management of rhinitis: an updated practice parameter. | journal=J Allergy Clin Immunol | year= 2008 | volume= 122 | issue= 2 Suppl | pages= S1-84 | pmid=18662584 | doi=10.1016/j.jaci.2008.06.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18662584 }} </ref><ref name="pmid18302831">{{cite journal| author=Blaiss MS| title=Pediatric allergic rhinitis: physical and mental complications. | journal=Allergy Asthma Proc | year= 2008 | volume= 29 | issue= 1 | pages= 1-6 | pmid=18302831 | doi=10.2500/aap2008.29.3072 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18302831 }} </ref> | The complications of rhinitis include the following:<ref name="pmid18331513">{{cite journal| author=Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A et al.| title=Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). | journal=Allergy | year= 2008 | volume= 63 Suppl 86 | issue= | pages= 8-160 | pmid=18331513 | doi=10.1111/j.1398-9995.2007.01620.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18331513 }} </ref><ref name="pmid18662584">{{cite journal| author=Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al.| title=The diagnosis and management of rhinitis: an updated practice parameter. | journal=J Allergy Clin Immunol | year= 2008 | volume= 122 | issue= 2 Suppl | pages= S1-84 | pmid=18662584 | doi=10.1016/j.jaci.2008.06.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18662584 }} </ref><ref name="pmid18302831">{{cite journal| author=Blaiss MS| title=Pediatric allergic rhinitis: physical and mental complications. | journal=Allergy Asthma Proc | year= 2008 | volume= 29 | issue= 1 | pages= 1-6 | pmid=18302831 | doi=10.2500/aap2008.29.3072 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18302831 }} </ref> | ||
* | * [[Conjunctivitis]] | ||
* [[Rhinosinusitis]] | * [[Rhinosinusitis]] | ||
* Chronic cough- One of the commonest causes of chronic cough is posterior | * [[Chronic cough, severe cold|Chronic cough]]- One of the commonest causes of chronic cough is posterior [[rhinorrhoea]]([[postnasal drip]]) | ||
* Fatigue | * [[Fatigue]] | ||
* Mouth breathing | * [[Mouth breathing]] | ||
* Aggravation of adenoidal hypertrophy<ref name="pmid19664013">{{cite journal| author=Sih T, Mion O| title=Allergic rhinitis in the child and associated comorbidities. | journal=Pediatr Allergy Immunol | year= 2010 | volume= 21 | issue= 1 Pt 2 | pages= e107-13 | pmid=19664013 | doi=10.1111/j.1399-3038.2009.00933.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19664013 }} </ref> | * Aggravation of adenoidal hypertrophy<ref name="pmid19664013">{{cite journal| author=Sih T, Mion O| title=Allergic rhinitis in the child and associated comorbidities. | journal=Pediatr Allergy Immunol | year= 2010 | volume= 21 | issue= 1 Pt 2 | pages= e107-13 | pmid=19664013 | doi=10.1111/j.1399-3038.2009.00933.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19664013 }} </ref> | ||
* Headache | * [[Headache]] | ||
* Poor sleep | * Poor sleep | ||
* Snoring | * [[Obstructive sleep apnea]] | ||
* Cognitive impairment | * [[Snoring]] | ||
* Hyperactivity | * [[Cognitive impairment]] | ||
* [[Hyperactivity]] | |||
* [[Eustachian tube dysfunction]] | * [[Eustachian tube dysfunction]] | ||
* [[Acute otitis media]]<ref name="pmid19664013">{{cite journal| author=Sih T, Mion O| title=Allergic rhinitis in the child and associated comorbidities. | journal=Pediatr Allergy Immunol | year= 2010 | volume= 21 | issue= 1 Pt 2 | pages= e107-13 | pmid=19664013 | doi=10.1111/j.1399-3038.2009.00933.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19664013 }} </ref> | * [[Acute otitis media]]<ref name="pmid19664013">{{cite journal| author=Sih T, Mion O| title=Allergic rhinitis in the child and associated comorbidities. | journal=Pediatr Allergy Immunol | year= 2010 | volume= 21 | issue= 1 Pt 2 | pages= e107-13 | pmid=19664013 | doi=10.1111/j.1399-3038.2009.00933.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19664013 }} </ref> | ||
| Line 25: | Line 27: | ||
* Aggravation of [[asthma]] | * Aggravation of [[asthma]] | ||
* [[Laryngitis]]<ref name="pmid21922973">{{cite journal| author=Turley R, Cohen SM, Becker A, Ebert CS| title=Role of rhinitis in laryngitis: another dimension of the unified airway. | journal=Ann Otol Rhinol Laryngol | year= 2011 | volume= 120 | issue= 8 | pages= 505-10 | pmid=21922973 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21922973 }} </ref> | * [[Laryngitis]]<ref name="pmid21922973">{{cite journal| author=Turley R, Cohen SM, Becker A, Ebert CS| title=Role of rhinitis in laryngitis: another dimension of the unified airway. | journal=Ann Otol Rhinol Laryngol | year= 2011 | volume= 120 | issue= 8 | pages= 505-10 | pmid=21922973 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21922973 }} </ref> | ||
* [[Hyposmia]] (usually mild) | |||
Allergic comorbidities associated with Allergic rhinitis include:<ref name="pmid18331513"></ref> | |||
* Allergic eye diseases<ref name="pmid27490123"></ref> | * Allergic eye diseases<ref name="pmid27490123"></ref> | ||
# [[Allergic conjunctivitis|Seasonal allergic conjunctivitis]] | # [[Allergic conjunctivitis|Seasonal allergic conjunctivitis]] | ||
| Line 32: | Line 35: | ||
# [[Vernal keratoconjunctivitis]] | # [[Vernal keratoconjunctivitis]] | ||
# [[Atopic keratoconjunctivitis]] | # [[Atopic keratoconjunctivitis]] | ||
* [[Asthma]] | * [[Asthma]]: Allergic rhinitis is strongly associated with the risk of developing asthma, and the coexistence of rhinitis with [[asthma]] is often associated with an increase in [[asthma]] severity.<ref name="pmid24958195">{{cite journal| author=Deliu M, Belgrave D, Simpson A, Murray CS, Kerry G, Custovic A| title=Impact of rhinitis on asthma severity in school-age children. | journal=Allergy | year= 2014 | volume= 69 | issue= 11 | pages= 1515-21 | pmid=24958195 | doi=10.1111/all.12467 | pmc=4209798 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24958195 }} </ref> | ||
* [[Atopic dermatitis]] | * [[Atopic dermatitis]] | ||
* [[Oral allergy syndrome]]<ref name="Allergic rhinitis-an overview of a common disease">{{cite journal |last=Rotiroti |first=Giuseppina |last2=Scadding |first2=Glenis |date=July 2016 |title=Allergic Rhinitis-an overview of a common disease |url=https://www-clinicalkey-com.ezp-prod1.hul.harvard.edu/#!/content/playContent/1-s2.0-S1751722216300063?returnurl=null&referrer=null&scrollTo=%23tbl2|journal=Paediatrics and Child Health |volume= Volume 26 |issue= Issue 7 |pages=298-303 |access-date=January 20, 2017 }} </ref> | |||
* [[Eosinophilic gastroenteritis]]<ref name="pmid 17052051">{{cite journal| author=Baig MA, Qadir A, Rasheed J| title=A review of eosinophilic gastroenteritis. | journal=J Natl Med Assoc | year= 2006 | volume= 98 | issue= 10 | pages= 1616-9 | pmid= 17052051 | doi= | pmc=2569760 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17052051 }} </ref> | |||
===Prognosis=== | ===Prognosis=== | ||
Resolution of allergic rhinitis occurs in only 10-20% of children within 10 years. A higher likelihood of remission has been documented in children with nonallergic rhinitis compared to the allergic type, with remission occurring within four years in about 73% of four year old children suffering from nonallergic rhinitis. Poorly treated rhinitis is strongly associated with a decreased quality of life and several other | Resolution of allergic rhinitis occurs in only 10-20% of children within 10 years.<ref name="pmid10094214">{{cite journal| author=Sly RM| title=Changing prevalence of allergic rhinitis and asthma. | journal=Ann Allergy Asthma Immunol | year= 1999 | volume= 82 | issue= 3 | pages= 233-48; quiz 248-52 | pmid=10094214 | doi=10.1016/S1081-1206(10)62603-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10094214 }} </ref> A higher likelihood of remission has been documented in children with nonallergic rhinitis compared to the allergic type, with remission occurring within four years in about 73% of four year old children suffering from nonallergic rhinitis.<ref name="pmid22056609" /> Poorly treated rhinitis is strongly associated with a decreased quality of life and several other co-morbidities.<ref name="Diseases of the Sinuses" /> | ||
==References== | ==References== | ||
Latest revision as of 12:31, 29 April 2017
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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
Rhinitis is a heterogeneous group of disorders that can significantly impact the quality of life of the affected individual[1] A heightened awareness of the condition and its potential debilitating comorbidities/complications is essential for a timely intervention.[1][2]
Natural History, Complications, Prognosis
Natural History
Rhinitis is a very common disease, and it is sometimes erroneously viewed as a trivial disease.[3][1] Allergic rhinitis rarely occurs in isolation, it is a product of a genetic predisposition, epigenetic events, and environmental exposures, and it is frequently associated with other forms of atopy such as eczema, asthma, and allergic eye disease(allergic rhinoconjunctivitis).[4][5][6] The vast majority of individuals with asthma have rhinitis, and allergic eye disease has been reported to affect almost all patients with allergic rhinitis.[4][7] Nonallergic rhinitis is also associated with asthma.[8][7] Frequent extension of rhinitis into the sinuses also occur, resulting in rhinosinusitis.[9][1] Children with nonallergic rhinitis have a higher likelihood of undergoing remission, compared with those with allergic rhinitis, who tend to have a more persistent disease.[8] Remission occurs in up to 73% of four year old children with nonallergic rhinitis by the age of eight years.[8] Rhinitis is a significant cause of lost school and work days, and it constitutes a huge financial burden to the society.[10][3] Untreated/poorly treated chronic rhinitis is associated with a diminished quality of life, disordered sleep, impaired work performance, and several other co-morbidities.[1][5]
Complications
The complications of rhinitis include the following:[7][3][11]
- Conjunctivitis
- Rhinosinusitis
- Chronic cough- One of the commonest causes of chronic cough is posterior rhinorrhoea(postnasal drip)
- Fatigue
- Mouth breathing
- Aggravation of adenoidal hypertrophy[12]
- Headache
- Poor sleep
- Obstructive sleep apnea
- Snoring
- Cognitive impairment
- Hyperactivity
- Eustachian tube dysfunction
- Acute otitis media[12]
- Otitis media with effusion
- Aggravation of asthma
- Laryngitis[13]
- Hyposmia (usually mild)
Allergic comorbidities associated with Allergic rhinitis include:[7]
- Allergic eye diseases[4]
- Seasonal allergic conjunctivitis
- Perennial allergic conjunctivitis
- Vernal keratoconjunctivitis
- Atopic keratoconjunctivitis
- Asthma: Allergic rhinitis is strongly associated with the risk of developing asthma, and the coexistence of rhinitis with asthma is often associated with an increase in asthma severity.[14]
- Atopic dermatitis
- Oral allergy syndrome[15]
- Eosinophilic gastroenteritis[16]
Prognosis
Resolution of allergic rhinitis occurs in only 10-20% of children within 10 years.[17] A higher likelihood of remission has been documented in children with nonallergic rhinitis compared to the allergic type, with remission occurring within four years in about 73% of four year old children suffering from nonallergic rhinitis.[8] Poorly treated rhinitis is strongly associated with a decreased quality of life and several other co-morbidities.[1]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 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.
- ↑ Skoner DP (2001). "Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis". J Allergy Clin Immunol. 108 (1 Suppl): S2–8. PMID 11449200.
- ↑ 3.0 3.1 3.2 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.
- ↑ 4.0 4.1 4.2 Shaker M, Salcone E (2016). "An update on ocular allergy". Curr Opin Allergy Clin Immunol. 16 (5): 505–10. doi:10.1097/ACI.0000000000000299. PMID 27490123.
- ↑ 5.0 5.1 Sacre Hazouri JA (2006). "[Allergic rhinitis. Coexistent diseases and complications. A review and analysis]". Rev Alerg Mex. 53 (1): 9–29. PMID 16634358.
- ↑ Mims JW (2014). "Epidemiology of allergic rhinitis". Int Forum Allergy Rhinol. 4 Suppl 2: S18–20. doi:10.1002/alr.21385. PMID 25182349.
- ↑ 7.0 7.1 7.2 7.3 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.
- ↑ 8.0 8.1 8.2 8.3 Westman M, Stjärne P, Asarnoj A, Kull I, van Hage M, Wickman M; et al. (2012). "Natural course and comorbidities of allergic and nonallergic rhinitis in children". J Allergy Clin Immunol. 129 (2): 403–8. doi:10.1016/j.jaci.2011.09.036. PMID 22056609.
- ↑ 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.
- ↑ Schoenwetter WF, Dupclay L, Appajosyula S, Botteman MF, Pashos CL (2004). "Economic impact and quality-of-life burden of allergic rhinitis". Curr Med Res Opin. 20 (3): 305–17. doi:10.1185/030079903125003053. PMID 15025839.
- ↑ Blaiss MS (2008). "Pediatric allergic rhinitis: physical and mental complications". Allergy Asthma Proc. 29 (1): 1–6. doi:10.2500/aap2008.29.3072. PMID 18302831.
- ↑ 12.0 12.1 Sih T, Mion O (2010). "Allergic rhinitis in the child and associated comorbidities". Pediatr Allergy Immunol. 21 (1 Pt 2): e107–13. doi:10.1111/j.1399-3038.2009.00933.x. PMID 19664013.
- ↑ Turley R, Cohen SM, Becker A, Ebert CS (2011). "Role of rhinitis in laryngitis: another dimension of the unified airway". Ann Otol Rhinol Laryngol. 120 (8): 505–10. PMID 21922973.
- ↑ Deliu M, Belgrave D, Simpson A, Murray CS, Kerry G, Custovic A (2014). "Impact of rhinitis on asthma severity in school-age children". Allergy. 69 (11): 1515–21. doi:10.1111/all.12467. PMC 4209798. PMID 24958195.
- ↑ Rotiroti, Giuseppina; Scadding, Glenis (July 2016). "Allergic Rhinitis-an overview of a common disease". Paediatrics and Child Health. Volume 26 (Issue 7): 298–303. Retrieved January 20, 2017.
- ↑ Baig MA, Qadir A, Rasheed J (2006). "A review of eosinophilic gastroenteritis". J Natl Med Assoc. 98 (10): 1616–9. PMC 2569760. PMID 17052051 17052051 Check
|pmid=value (help). - ↑ Sly RM (1999). "Changing prevalence of allergic rhinitis and asthma". Ann Allergy Asthma Immunol. 82 (3): 233–48, quiz 248-52. doi:10.1016/S1081-1206(10)62603-8. PMID 10094214.