ALLERGIC

RHINITIS
NURAIN BALQIS 260110152011
MOHD. SUFFIAN 260110152013
NUR SYAHIRAH 260110152016
LOLINDAH CHIN 260110152018
Allergic rhinitis is a diagnosis associated with a group of symptoms affecting the nose. These symptoms
occur when you breathe in something you are allergic to, such as dust, animal dander, or pollen

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 INTRODUCTION
Nearly 8 percent of adults in the United States experience allergic rhinitis of
some kind, according to the American Academy of Allergy, Asthma &
Immunology (AAAAI).

Between 10 to 30 percent of the worldwide population may also have allergic

rhinitis.

Allergic rhinitis is commonly known as hay fever.

Common symptoms include sneezing, stuffy nose, watery eyes, and a sore,
scratchy throat.

Possible triggers include grass, pollen, dust mites, cockroaches, cigarette

smoke, and perfume. 3
 Rhinitis, which occurs most commonly as allergic rhinitis, is an
inflammation of the nasal membranes that is characterized by sneezing,
nasal congestion, nasal itching, and rhinorrhea, in any combination.

Although allergic rhinitis itself is not life-threatening (unless accompanied

by severe asthma or anaphylaxis), morbidity from the condition can be
significant.

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Pathology
Sensitization to allergens

Antigen presenting cells (APCs), such as dendritic cells in the mucosal surface, process
allergens and present some peptides from allergens on the major histocompatibility complex
(MHC) class II molecule.

This MHC class II molecule and antigen complex take a role as the ligand of T-cell receptors
on Naive CD4+ T cells, which result in differentiation of Naive CD4+ T cells to allergen-
specific Th2 cell.

Activated Th2 cells secret several cytokines, which induce isotype switching of B cells to
produce specific IgE and proliferation of eosinophils, mast cells and neutrophils. Produced
antigen-specific IgE binds to high-affinity IgE receptors on mast cells or basophils.
Early and late reactions

When AR patients are exposed to allergens, allergic reactions develop

in 2 different patterns according to time sequence.

One is the early reaction, in which sneezing and rhinorrhea develops in

30 minutes and disappears. The early reaction is the response of mast
cells to offending allergens (type I hypersensitivity). Stimulated mast
cells induce nasal symptoms by secreting chemical mediators such as
histamine, prostaglandins and leukotrienes.

The other is the late reaction, which shows nasal obstruction

approximately 6 hours after exposure to allergens and subsides slowly.
Neurogenic inflammation

When respiratory epithelium is destroyed and nerve endings are exposed

by cytotoxic proteins from eosinophils, sensory nerve fibers are excited
by nonspecific stimuli and stimulate both sensory afferent and
surrounding efferent fibers, the socalled retrograde axonal reflex.

This makes the sensory nerve fibers secrete neuropeptides such as

substance P and neurokinin A, which induce contraction of smooth
muscles, mucous secretion of goblet cells and plasma exudation from
capillaries
 Signs and symptoms
Sneezing, Itching: Nose, eyes,
ears, palate, Rhinorrhea,
Postnasal drip, Congestion,
Anosmia, Headache, Earache,
Tearing, Red eyes, Eye swelling,
Fatigue, Drowsiness and Malaise
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Diagnosis
Laboratory tests used in the diagnosis of allergic rhinitis include the following:
Allergy skin tests (immediate hypersensitivity testing):
Fluorescence enzyme immunoassay (FEIA):
Total serum IgE:
Total blood eosinophil count

Imaging studies used in the diagnosis and evaluation of allergic rhinitis include the
following:
Radiography
Computed tomography scanning: Can be very helpful for evaluating acute or chronic
sinusitis
Magnetic resonance imaging: Also can be helpful for evaluating sinusitis
 TREATMEN
T
Treatments for allergic rhinitis include:

ANTIHISTAMINES

Medicines called antihistamines work well for treating allergy symptoms. They
may be used when symptoms do not happen often or do not last long.

CORTICOSTEROIDS

Nasal corticosteroid sprays are the most effective treatment for allergic rhinitis.
They work best when used nonstop, but they can also be helpful when used for
shorter periods of time.
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DECONGESTANTS
Decongestants
may also be helpful for reducing
symptoms such as nasal stuffiness.
Donot use nasal spray decongestants for more than 3
days.

OTHER MEDICINES
Leukotriene inhibitors are prescription medicines that
block leukotrienes. These are the chemicals the body
releases in response to an allergen that also trigger
symptoms.
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