ALLERGIC RHINITIS

By : Widia Zalvi
1310070100145

Supervisor :

Dr. Fauziah Henny, Sp.THT-KL

DEPARTMENT OF OTORHINOLARYNGOLOGY-HEAD AND NECK

DR.PIRNGADI GENERAL HOSPITAL
MEDAN
2018
Introduction

 Rhinitis is defined as inflammation of the nasal membranes by a symptom :

sneezing, nasal congestion, nasal itching, and rhinorrhea

 Epidemiology : - in indonesian : 38,2% incident (female 66%, male 44%)

- United States : 19% incident (female 52,9%, male 47,1%)

 Sign and symptom : sneezing, watery and nasal discharge,itching and nasal
obstruction.

 Treatment of Allergic Rhinitis is pharmacology

 The External
Anatomy of the nose Nose

The External Nose

The Internal
Nose
 Rhinitis is defined as inflammation of the nasal
membranes and is characterized by a symptom complex that
consists of any combination of the following:
Sneezing
nasal congestion
nasal itching
and rhinorrhea

Allergic Rhinitis ?
 Epidemiology

70% 66%

60%
52.9%
50% 47%
44%
40%

30%

20%

10%

0%
Indonesian (38,2%) United states (19%)
Male Female
 • pollen
Inhaled • feathers
• Dust mite
• Eggs
Ingested • milk
• nuts

• penicillin
Injected • Bee sting

• Cosmetic ingredients
Contact • jewelry

Etiology ?
Pathophysiology?
 Signs and
Symptoms

Sneezing Earache Tearing

Itching: Nose,
eyes, ears, Headache Red eyes
palate

Rhinorrhea Anosmia Eye swelling Malaise

Postnasal drip Congestion Fatigue Drowsiness

ARIA (Allergic Rhinitis and Its Impact on Asthma)
Classification
Diagnosis :

• Allergy skin tests (immediate hypersensitivity testing): An in vivo method

of determining immediate (IgE-mediated) hypersensitivity to specific
allergens
• Total serum IgE: Neither sensitive nor specific for allergic rhinitis, but the
results can be helpful in some cases when combined with other factors

Differential Diagnosis :

 Non inflammatory rhinopathy (also know as vasomotor rhinitis)

 Non allergic chronic rhinosinusitis
 TREATMENT :

• Pharmacotherapy :

 Antihistamin
 Nasal corticosteroids
 Decongestants

• Allergen immunotherapy :

 Subcutaneous immunotherapy
 Sublingual immunotherapy
 Conclusions

 Most cases of allergic rhinitis respond to pharmacotherapy. Patients

with intermittent symptoms are often treated adequately with oral
antihistamines, decongestants, or both as needed. Regular use of an
intranasal steroid spray may be more appropriate for patients with
chronic symptoms.

 Allergen immunotherapy should be used in patients with refractory

symptoms or in those for whom pharmacotherapy is associated with
unacceptable side affect

 Two forms of allergen immunotherapy are now available :

subcutaneous injection and rapidly dissolving sublingual tablet.