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At least 19 recordsLinked to original sources
PubMed1991

[Differentiation between allergic rhinitis and vasomotor rhinitis. Light and electron microscopic studies].

The pathological changes of nasal mucosa from allergic rhinitis and vasomotor rhinitis were observed. The results showed that the general characteristic was vascular dilatation with increased permeability and glandular proliferation with increased secretory activity. The pathological difference between mucous membranes of allergic and vasomotor rhinitis were mainly cellular infiltration and degree of damage on vascular wall. In allergic rhinitis there were more eosinophils, basophils, neutrophils and some mast cells and plasma cells in nasal mucosa. Gap formation in capillary wall was found in allergic nasal mucosa, there were less cellular infiltration and no gap formation in vasomotor rhinitis.

Diagnosis, Differential↗
PubMed1992

Rhinitis during pregnancy and rhinitis medicamentosa.

Vasomotor rhinitis is a nonspecific disorder that is caused neither by infection nor allergy but rather by an imbalance of the autonomic nervous system with a preponderant action of parasympathetic fibers on nasal blood vessels. Rhinitis during pregnancy appears to result from the increased production of estrogen; increased estrogen levels caused by treatment, puberty, or liver disease may also cause rhinitis. Nasal saline mist, antihistamines, and topical corticosteroids are recommended; intranasal corticosteroid injections are also useful but must be administered under expert care. Rhinitis medicamentosa results from overuse of topical vasoconstrictors, which produce a rebound phenomenon. Rebound can also result from numerous medications, including antihypertensive preparations that reduce catecholamine levels, antidepressants, antipsychotics, and tranquilizers. Management of rhinitis medicamentosa consists in limiting the use of vasoconstrictors to no more than 3 days and giving the patient saline nasal sprays, daytime oral vasoconstrictors, and nocturnal antihistamines. Corticosteroids, preferably topical nasal steroids rather than even a short-term course of systemic administration, should also be used.

Adrenal Cortex Hormones↗
PubMed1991

Epidemiology of seasonal and perennial rhinitis: clinical presentation and medical history.

BACKGROUND: Little is known about the epidemiology of rhinitis, particularly the perennial and non-allergic forms. The aim of this study was to compare the symptoms, atopic state, and medical history of individuals with seasonal and perennial rhinitis. DESIGN: Of 7702 adults aged 16-65 years registered with a London general practice, 2969 (30%) were screened by postal questionnaire. Samples of 113 subjects without rhinitis, 51 with seasonal symptoms alone, 128 with perennial symptoms and seasonal exacerbations were then interviewed. Atopic and non-atopic subjects were distinguished by skinprick testing with five common allergens. RESULTS: The estimated minimum prevalence of rhinitis was 24%: 3% had seasonal symptoms only, of whom 78% were atopic; 13% had perennial symptoms only, of whom 50% were atopic; and 8% had perennial symptoms with seasonal exacerbations, of whom 68% were atopic. Seasonal rhinitis was characterised by sneezing, itching, and a high prevalence of diurnal variation in symptoms. The most common provoking factors were dust, pollens, and infections. By comparison, perennial rhinitis was characterised by a higher prevalence of nasal blockage and catarrh, and a lower prevalence of diurnal variation and provocation by pollen. There were no significant differences among the groups in the sociodemographic characteristics examined. Subjects with seasonal rhinitis were more likely to be atopic and to have eczema and a family history of hayfever than those without rhinitis. Those with perennial rhinitis were more likely to have past or current eczema or migraine, be wheezy or labelled asthmatic, or have a family history of nose trouble other than hayfever. Subjects with both seasonal and perennial symptoms presented an intermediate clinical picture. CONCLUSIONS: Seasonal and perennial rhinitis differ in their atopic state, clinical presentation, and medical history. The extent to which these differences are genetically or environmentally determined requires further investigation.

Adult↗
PubMed1979

Large airway constriction in allergic rhinitis: response to inhalation of helium-oxygen.

Pulmonary function results were compared in 15 allergic rhinitis and 30 normal subjects. Airways resistance (RAW) was higher (p less than 0.01) and specific conductance (SGAW) and lower (p less than 0.01) in the rhinitis group. Maximal expiratory flow (VeMax), lung volumes, and results of tests measuring airways closure, distribution of ventilation, diffusing capacity, volume of isoflow, and density-dependence of VeMax at 50% of vital capacity (deltaVeMax50) did not differ significantly between the two groups. Following inhalation of isoproterenol, RAW decreased and SGAW and VeMax increased significantly in both groups. On the other hand, delta-VeMax50 decreased significantly in the rhinitis group (p less than 0.01) and increased significantly in the control group (p less than 0.05). In addition to comparing pulmonary function in rhinitis patients and control subjects, physiologic measurements were also made on two separate occasions in the rhinitis subjects (minimal or no symptoms; very symptomatic). Although rhinitis symptomatology varied considerably (p less than 0.001), pulmonary function results were not significantly different. Hence we conclude that: (1) Rhinitis subjects have large airway constriction which does not vary with season or symptoms. (2) As in normal control subjects, airflow limitation occurs in the large airways of rhinitis subjects. (3) The predominant site of isoproterenol-associated bronchodilatation differs between allergic rhinitis and normal subjects.

Adult↗
PubMed1992

A 10-year prognosis for childhood allergic rhinitis.

The prognosis of allergic rhinitis was studied in 154 children aged 3-17 years at diagnosis by means of a detailed questionnaire administered 8-11 years later. The symptoms had completely disappeared in only 15 (10%) patients. The conjunctival symptoms, however, had disappeared or were controlled successfully by topical drug therapy in almost all, and 77 (50%) were managing without medication for allergic rhinitis. Twenty-five (23%) of the 110 children with seasonal allergic rhinitis had a perennial disease at follow-up, in contrast to seven (16%) of 44 with perennial allergic rhinitis originally who had only seasonal symptoms at follow-up. Asthma or wheezing had developed in 29 cases (19%) and was more common (p less than 0.01) among those with perennial allergic rhinitis (15 of 44) than among those with seasonal allergic rhinitis (14 of 110). No significant association was found between age at onset of symptoms, family history of atopic disease or type of treatment for allergic rhinitis and allergic rhinitis still present at follow-up or development of asthma during the observation period.

Adolescent↗
PubMed1978

Perennial rhinitis: an analysis of skin testing, serum IgE, and blood and smear eosinophilia in 201 patients.

Allergen skin testing, eosinophil counting in blood and nasal smear and serum IgE determination were performed in patients with simple perennial rhinitis, and in patients with rhinitis and asthma. The results were compared with those obtained in normal controls. As a positive skin test was demonstrated in 40% of patients with simple rhinitis and in 88% of patients with rhinitis and asthma, skin testing is considered relevant in all patients with perennial rhinitis. While blood eosinophil count and serum IgE level were elevated in a fair proportion of asthmatic patients, only a few subjects with simple perennial rhinitis had an elevated level, and the diagnostic values of these tests is questionable. On the other hand, examination of a nasal smear for eosinophils could usually separate the patients from the controls. The study emphasizes the importance of making a distinction between simple perennial rhinitis and perennial rhinitis associated with other symptoms and diseases.

Adolescent↗
PubMed1978

[Contamination and age as factors in the pathogenesis of atrophic rhinitis (author's transl)].

The relationship between contamination with Bordetella bronchiseptica or Pasteurella multocida and the age of the piglets on the one hand and the pathogenesis of atrophic rhinitis on the other, is discussed. Minimal disease-free piglets born and reared on farms on which pigs affected with clinical atrophic rhinitis were present, developed clinical atrophic rhinitis at the age of six weeks. Piglets born in the Central Veterinary Institute (CVI) of sows from herds including pigs affected with atrophic rhinitis and reared under normal CVI conditions, did not develop clinical atrophic rhinitis. These sows are believed to be factors of minor importance in the pathogenesis of clinical atrophic rhinitis in piglets. When minimal disease-free piglets were contaminated during the third or fourth week of life, a slight degree of foreshortening of the upper jaw was observed in three out of nine pigs, the carcase weights of these animals not differing markedly from those of normal swine. When they were contaminated at the age of eight weeks, clinical atrophic rhinitis did not appear. It is essential that young piglets should be protected against atrophic rhinitis during the first few weeks of life.

Age Factors↗
PubMed1992

Genetic risk for asthma, allergic rhinitis, and atopic dermatitis.

In order to explore the genetic risk of a child with a family history of allergies developing asthma, allergic rhinitis, or atopic dermatitis, questionnaires filled in by 6665 families were analysed. The data were collected in a population based cross sectional survey of 9-11 year old schoolchildren living in Munich and southern Bavaria. The relation between asthma, allergic rhinitis, and atopic dermatitis and the number of allergic first degree relatives, and the type of allergic disease was examined. Analyses were done separately for families with single or multiple allergic diseases. In families with one allergic parent the risk of the child developing asthma was increased by asthma in a parent, with an odds ratio (OR) of 2.6 (95% confidence interval 1.7 to 4.0) but not by parental allergic rhinitis with OR 1.0 (0.7 to 1.5) or atopic dermatitis, OR 1.0 (0.6 to 1.6). For allergic rhinitis the highest risk with OR 3.6 (2.9 to 4.6) was observed with allergic rhinitis of one parent, apparently lower for asthma of one parent, OR 2.5 (1.6 to 4.0) or atopic dermatitis, OR 1.7 (1.1 to 2.5). Children with parental atopic dermatitis had a high risk for atopic dermatitis, OR 3.4 (2.6 to 4.4), compared with children with parental asthma, OR 1.5 (1.0 to 2.2), or parental allergic rhinitis, OR 1.4 (1.1 to 1.8). Risk factors in families with combined allergies of two relatives (parents and siblings) were analysed separately for the different combinations. These results support the hypothesis that asthma, allergic rhinitis, and atopic dermatitis are multifactorial diseases brought about by various familial and environmental influences.

Asthma↗
PubMed1992

HLA-DR2, [HLA-B7, SC31, DR2], and [HLA-B8, SC01, DR3] haplotypes distinguish subjects with asthma from those with rhinitis only in ragweed pollen allergy.

MHC haplotypes were determined for 52 patients with ragweed pollen allergy, with and without asthma, and 27 non-atopic controls. Total IgE levels were unimodally distributed in all study groups and were higher in atopic patients in general compared with non-atopics. There was no difference in total IgE levels in patients with rhinitis only compared with those with rhinitis and asthma. IgE anti-Amb a V was detected (after subtraction of values representing the means + 2 SD of the non-atopics) in 9 of 20 asthmatics but only 3 of 32 patients with only rhinitis and was thus associated with asthma. Mean anti-Amb a V was much higher in the antibody-positive asthmatics (1710 U/ml) than in the positive patients with rhinitis only (469 U/ml). The extended MHC haplotype [HLA-B7, SC31, DR2] and its possible DR-containing fragment (SC31, DR2), were found almost exclusively among the patients with IgE anti-Amb a V and were significantly elevated in patients with asthma. DR2 in general, but not DR2 without SC31, was significantly increased in frequency in patients with anti-Amb a V. In contrast, the extended haplotype [HLA-B8, SC01, DR3] and DR3 in general were increased among patients with rhinitis only and patients without IgE anti-Amb a V compared with general controls. Thus, [HLA-B8, SC01, DR3] and DR3 appear to be "protective" for the production of this antibody and the occurrence of asthma. The findings are consistent with an MHC-linked gene or genes on [HLA-B7, SC31, DR2] (but not necessarily DR2, Dw2, or DQw6 in general) controlling the IgE immune response to Amb a V and associated with asthma in ragweed pollen-sensitive subjects. In patients with rhinitis alone and generally undetectable levels of IgE anti-Amb a V, the increase in [HLA-B8, SC01, DR3] and DR3 may mark a response to an as yet unidentified Ag associated with ragweed allergy and rhinitis only.

Asthma↗
PubMed1975

Nasal mucosal hyperpermeability to macromolecules in atopic rhinitis and extrinsic asthma.

This study was designed to test the hypothesis that patients with atopic rhinitis and extrinsic asthma have a nasal mucous membrane defect that allows inhaled macromolecules access to immunocompetent cells. Three groups were studied: normal subjects, patients with extrinsic asthma, and patients with atopic rhinitis. Albumin 125I(20 muc) was applied to the nasal mucosa and venous blood samples were drawn at set intervals up to 4 hours. Thirty-two minutes after administration, a significantly greater percentage of the dose was found in the plasma of patients with atopic rhinitis than in that of normal subjects (p smaller than 0.001). Transport of intact albumin across the nasal mucosa was demonstrated by dialysis, gel filtration, and immunopercipitation experiments in 3/9 normal subjects, 1/9 patients with asthma, and 9/10 patients with rhinitis (p smaller than 0.02). These studies suggest that large, potentially antigenic molecules pass more readily across the nasal mucous membrane of patients with allergic rhinitis than that of normal subjects. No increase in nasal transport was seen in patients with extrinsic asthma. It has not been determined whether this defect is a cause or an effect of atopic rhinitis.

Administration, Intranasal↗
PubMed1991

Postcoital asthma and rhinitis.

Sexual intercourse as a trigger factor for attacks of asthma and/or rhinitis and the morbidity caused thereof is not well recognized. We present four patients (three males and one female) with postcoital asthma and/or rhinitis. Acute severe asthma subsequent to sexual intercourse in one male patient had resulted in several emergency department visits and hospitalization on one occasion. Anxiety was a predominant feature in the patients and their spouses that had interfered with their sexual life and worsened their disease. Late asthmatic response, on occasions, occurred in two patients. None of the patients developed wheezing dyspnea or rhinitis, nor did they have a fall in peak expiratory flow rates on climbing two flights of stairs, an exercise considered equivalent to energy expended during sexual intercourse. Thus, sexual excitement rather than exercise appeared to be the cause of postcoital asthma and rhinitis. Adequate pharmacotherapy along with counseling of the patients and their spouses restored normal sexual function and control of asthma and rhinitis. Postcoital asthma and rhinitis can easily be overlooked due to patient embarrassment and lack of physician awareness.

Adult↗
PubMed1979

Metabolism of cyclic nucleotides in allergic rhinitis: studies on lymphocytes, granulocytes, and plasma level.

The effect of isoproterenol on the cyclic nucleotide level in peripheral lymphocytes and granulocytes with allergic rhinitis patients and normal subjects has been studied. Responsiveness to 10(-5) M isoproterenol of lymphocytes decreased in the case of allergic rhinitis patients. When asthma was complicated to perennial rhinitis, a more significant depression was noted. In granulocytes the same tendency as with lymphocytes was noted although the difference was not significant. Basal level and responsiveness to 5 X 10(-3) M theophylline of both lymphocytes and granulocytes were similar in allergic rhinitis patients to normal subjects. The ratio of plasma cAMP to cGMP concentration was lower in the allergic rhinitis patients although the difference was not significant.

Adolescent↗
PubMed1990

Antihistamine therapy in allergic rhinitis.

Allergic rhinitis is a common disorder that is associated with a high incidence of morbidity and considerable costs. The symptoms of allergic rhinitis are primarily dependent upon the tissue effects of histamine. Antihistamines are the mainstay of therapy for allergic rhinitis. Recently, a second generation of antihistamines has become available. These agents lack the adverse effect of sedation, which is commonly associated with older antihistamines. Current practice of antihistamine therapy in allergic rhinitis often involves random selection among the various agents. Based upon the available clinical trials, chlorpheniramine appears to be the most reasonable initial antihistaminic agent. A nonsedating antihistamine should be used initially if a patient is involved in activities where drowsiness is dangerous. In this comprehensive review of allergic rhinitis and its treatment, the current as well as future options in antihistamine pharmacotherapy are emphasized.

Histamine H1 Antagonists↗
PubMed1992

The anticholinergic treatment of allergic perennial rhinitis.

Anticholinergic agents have been used for nonallergic rhinitis expressly to control rhinorrhea. In allergic rhinitis, rhinorrhea can be extremely troublesome and unresponsive to traditional pharmacotherapeutic rhinitis treatments. Anticholinergic agents, through their specific ability to decrease nasal secretory response, should have beneficial effects for allergic rhinitis. In a recent trial ipratropium bromide at concentrations of 0.03% and 0.06% reduced rhinorrhea in allergic subjects without any demonstrable rebound effect. Therefore anticholinergic therapies may be a useful adjunct in controlling the rhinorrhea associated with allergic rhinitis.

Adolescent↗