Allergic rhinitis: Broader disease effects and implications for management

Section of Otolaryngology and Head and Neck Surgery, Pritzker School of Medicine, The University of Chicago, Illinois, USA.
Otolaryngology Head and Neck Surgery (Impact Factor: 2.02). 06/2003; 128(5):616-31. DOI: 10.1016/S0194-5998(03)00257-2
Source: PubMed


Allergic rhinitis is a burdensome disease for a significant part of the population in both adults and children. Poorly controlled allergic rhinitis can trigger exacerbations of asthma, sinusitis, and otitis media, diseases with which it shares common pathophysiologic elements. Consequently, early diagnosis and treatment should be a priority for patients and physicians, not only to control the symptoms of allergic rhinitis but also to improve the management of associated diseases. Several pharmacologic therapies can be considered in an armamentarium that includes antihistamines (intranasal and systemic), intranasal cromolyn, intranasal anticholinergic agents, intranasal steroids, systemic steroids, immunotherapy, and, most recently, leukotriene receptor antagonists. Often, combinations of these treatments are used to maximize control of refractory symptoms.

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    • "To date, the mechanism and immunological aspects of allergy have been studied [5] [6], but the host and environment risk factors related to the expression of childhood allergic rhinitis are poorly understood [7]. The aim of our study was to investigate the incidence and the prenatal risk factors of allergic rhinitis among elementary school children in an urban city. "
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    ABSTRACT: To investigate the incidence and prenatal risk factors for allergic rhinitis among elementary school children in an urban city. Risk factor data were collected by questionnaire and direct physical examination. Multiple logistic regression analysis was used to calculate the odds ratios of developing allergic rhinitis among children 6-13 years of age. From January 2006 to December 2006, we enrolled 1368 elementary school children in the study. Sampling was done by a multi-stage clustered-stratified random method to determine the study subject. All the children studied attended 12 elementary schools located in the six districts in Taipei, with two schools in each district. Odds ratios were adjusted for the confounding effects of gender, parity, maternal age at childbirth, maternal education, gestational complications, tobacco smokers in the residence, pets, carpets, molds, and air pollution. The incidence of allergic rhinitis in the study was 50.1% (685/1368). Factors like gender (p<.001), parity (p<.05), carpets (p<.025), and air pollution (p<.001) increased risk, while the other factors did not (p>.05 for all). Gender, parity, carpets, and air pollution increased the risk of developing allergic rhinitis among elementary school children. Other potential factors such as low birth weight, maternal age at childbirth, parental education, gestational complications, presence of tobacco smokers, and exposure to pets and molds did not significantly increase risk of developing allergic rhinitis.
    International journal of pediatric otorhinolaryngology 03/2009; 73(6):807-10. DOI:10.1016/j.ijporl.2009.02.023 · 1.19 Impact Factor
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    • "Allergic rhinitis is an IgE-mediated disease in which exposure to an inhaled antigen elicits inflammatory changes in the nasal mucosa, resulting in a variety of nasal and non-nasal symptoms [8]. The prevalence of allergic rhinitis in the population of the United States is estimated to range between 10% and 30% of the adult population [9]. "
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    ABSTRACT: The association between chronic rhinosinusitis (CRS) and allergy of the upper respiratory system has been discussed for many years,but much of this discussion has been anecdotal. Although epidemiologic evidence supports the increased prevalence of CRS among patients who have allergic rhinitis, and treatment of upper airway inflammation and allergy has been shown to decrease morbidity in patients who have CRS, but pathophysiologic mechanisms linking the two disease states have not been well elucidated. This article examines data supporting the link between upper airway allergic disease and CRS. It proposes a frame work for the treatment of CRS, with consideration of managing the allergic inflammation commonly noted in this disease. Finally, it discusses avenues for potential future research in evaluating the comorbidities of allergic inflammation and CRS.
    Otolaryngologic Clinics of North America 01/2006; 38(6):1257-66, ix-x. DOI:10.1016/j.otc.2005.07.002 · 1.49 Impact Factor
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    ABSTRACT: To determine the effect of allergic rhinitis (AR), asthma, rhinobronchitis (ARB) on dental malocclusion in adolescents. This is a cross-sectional, observational, retrospective and sample descriptive study of 2556 adolescents aged 14-20 years. AR, asthma and ARB were defined by self-reported. Malocclusion was identified by direct physical examination. Data were analyzed by the SPSS 10.0 version statistical program, adjusted OR value (Odds Ratio) using a logistic regression model was determined, ji square was calculated, an 95% Confidence Intervals was used. Equal or smaller values of p < 0.05 were considered statistically significant. Percentage of male sex was 42.7% and female 57.3%. Prevalence of AR was 39.3%, asthma 6.9%, ARB 4.5%, and malocclusion, 37.2%. A higher percentage of malocclusion was found in adolescents with asthma (48.3% vs 36.3%). For the groups of asthma (adjusted OR = 1.78; p = 0.017) and RA (fit OR = 1.20, p = 0.032) were inferred that these pathologies to favor the malocclusion in adolescents, this did not happen with the group of RBA (OR fit = 0.81; p = 0.511). The prevalence of open bite was greater in adolescents with asthma (44.3% vs. 31.3%). For the asthma group (OR fit = 1.66; p = 0.037) we deduced that the development of anterior open bite is favored, this was not thus for the groups of RBA (OR fit = 1.01; p = 0.956) and RA (OR fit = 1.17; p = 0.071). Nor AR, asthma orARB have any effect on posterior open bite. Asthma is related to malocclusion in adolescents, particularly to anterior open bite. AR and ARB do not favor the development of malocclusion.
    Alergia 54(5):169-76.
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