Allergic rhinitis, also known as pollenosis or hay fever, is an allergic inflammation of the nasal airways. It occurs when an allergen, such as pollen or dust, is inhaled by an individual with a sensitized immune system. In such individuals, the allergen triggers the production of the antibody immunoglobulin E (IgE), which binds to mast cells and basophils containing histamine.
IgE bound to mast cells are stimulated by pollen and dust, causing the release of inflammatory mediators such as histamine (and other chemicals). This causes itching, swelling, and mucus production. Symptoms vary in severity between individuals. Very sensitive individuals can experience hives or other rashes. Particulate matter in polluted air, and chemicals such as chlorine and detergents, which can normally be tolerated, can greatly aggravate allergic rhinitis. The physician John Bostock first described hay fever in 1819 as a disease.
Allergic rhinitis may also be classified as Mild-Intermittent, Moderate-Severe intermittent, Mild-Persistent, and Moderate-Severe Persistent. Intermittent is when the symptoms occur <4 days per week or <4 consecutive weeks. Persistent is when symptoms occur >4 days/week and >4 consecutive weeks. The symptoms are considered mild with normal sleep, no impairment of daily activities, no impairment of work or school, and if symptoms are not troublesome. Severe symptoms result in sleep disturbance, impairment of daily activities, and impairment of school or work. These symptoms may cause cough, cold or obstruction to respiratory passage while breathing.
Characteristic physical findings include conjunctival swelling and erythema, eyelid swelling, lower eyelid venous stasis, lateral crease on the nose, swollen nasal turbinates, and middle ear effusion.
Sufferers might also find that cross-reactivity occurs. For example, someone allergic to birch pollen may also find that they have an allergic reaction to the skin of apples or potatoes. A clear sign of this is the occurrence of an itchy throat after eating an apple or sneezing when peeling potatoes or apples. This occurs because of similarities in the proteins of the pollen and the food. There are many cross-reacting substances.
Some disorders may be associated with allergies: Comorbidities include eczema, asthma and depression
Allergic rhinitis triggered by the pollens of specific seasonal plants is commonly known as "hay fever", because it is most prevalent during haying season. However, it is possible to suffer from hay fever throughout the year. The pollen which causes hay fever varies between individuals and from region to region; generally speaking, the tiny, hardly visible pollens of wind-pollinated plants are the predominant cause. Pollens of insect-pollinated plants are too large to remain airborne and pose no risk. Examples of plants commonly responsible for hay fever include:
Allergy testing may reveal the specific allergens an individual is sensitive to. Skin testing is the most common method of allergy testing. This may include intradermal, scratch, patch, or other tests. Less commonly, the suspected allergen is dissolved and dropped onto the lower eyelid as a means of testing for allergies. (This test should only be done by a physician, never the patient, since it can be harmful if done improperly). In some individuals who cannot undergo skin testing (as determined by the doctor), the RAST blood test may be helpful in determining specific allergen sensitivity.
Systemic steroids such as prednisone are effective at reducing nasal inflammation, but their use is limited by their short duration of effect and the side effects of prolonged steroid therapy.
Antihistamine drugs can have undesirable side-effects, most notably drowsiness. First generation antihistamine drugs such as diphenhydramine cause drowsiness, but not second- and third-generation antihistamines such as cetirizine and loratadine.
Antihistamine drugs can be taken orally to control symptoms such as sneezing, rhinorrhea, itching and conjunctivitis. It is best to take the medication before exposure, especially for seasonal allergic rhinitis. Ophthalmic antihistamines (such as ketotifen) are used for conjunctivitis; intranasal forms are used for sneezing, rhinorrhea and nasal pruritus.
Pseudoephedrine is also indicated for vasomotor rhinitis. It is only used when nasal congestion is present and can be used with antihistamines. In the United States, oral decongestants containing pseudoephedrine must be purchased behind the pharmacy counter by law to combat the making of methamphetamine.
Topical decongestants: may also be helpful in reducing symptoms such as nasal congestion, but should not be used for long periods as stopping them after protracted use can lead to a rebound nasal congestion (Rhinitis medicamentosa).
For nocturnal symptoms, intranasal corticosteroids can be combined with nightly oxymetazoline, an adrenergic alpha-agonist, without risk of rhinitis medicamentosa.
Category:Allergology Category:Type 1 hypersensitivity
ar:حساسية الأنف ca:Rinitis al·lèrgica cs:Alergická rýma cy:Clefyd y gwair de:Allergische Rhinitis et:Pollinoos es:Rinitis alérgica fr:Rhinite allergique ga:Fiabhras léana hr:Alergijski rinitis it:Rinite allergica he:קדחת השחת lt:Šienligė nl:Hooikoorts ja:花粉症 no:Pollenallergi pl:Katar sienny pt:Febre dos fenos ru:Поллиноз szl:Ryma alergiczno fi:Heinänuha sv:Pollenallergi th:ไข้ละอองฟาง zh:過敏性鼻炎This text is licensed under the Creative Commons CC-BY-SA License. This text was originally published on Wikipedia and was developed by the Wikipedia community.
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