2.1 The Keys to Success

The best way to find a solution to a problem is to first define it. Once you know exactly what you’re dealing with, you’re much closer to accomplishing your goal. In immunology the goal is to determine the best type of allergy treatment for the patients. Classifying what type of allergic rhinitis patients have is useful in guiding not just the selection of what antigens you may test patients for, but also what pharmaceutical treatments you might use and determining if immunotherapy is the best option.

2.2 The Definition

What is allergic rhinitis? Allergic rhinitis is an inflammatory condition of the nasal mucosa mediated by immunoglobulin E (IgE) sensitization to an aeroallergen (type I hypersensitivity), which causes sneezing, nasal congestion, and clear nasal drainage when exposed to the allergen in question. The diagnosis of this disorder is made when a patient exhibits or gives a history of symptoms of allergic rhinitis with positive testing for IgE to one or more suspect antigens.

Local IgE production and sensitization can affect other mucosal surfaces. Thus, allergic conjunctivitis is similar in definition to allergic rhinitis, but it afflicts the eye. Allergic pharyngitis affects the pharynx, allergic laryngitis affects the larynx, and allergic asthma affects the lungs.

2.3 The Not-So-Perfect Classification System

The classification of allergic rhinitis is dependent on the timing and persistence of symptoms and how the disease has evolved over the years. Most practitioners are familiar with the terms “seasonal” and “perennial.” The Allergic Rhinitis in Asthma (ARIA) guidelines introduced new terms because the older terms didn’t quite seem to fully describe the different types of allergic rhinitis. The ARIA guidelines recommend that the newer terms should not be used along with the older terminology. However, it’s still very common to use older words, or even combine them with the newer ones (despite what the guidelines say), as the ARIA guideline terms also don’t cover all the types either.

It is important to use the chosen terms or classification system routinely and remain consistent (not just in your own practice, but with any partners you have, as well). Documenting the timing of symptoms is key to selecting antigens for testing and treatment. Classifying the type of allergic rhinitis helps solidify that timing in your documentation. Some classification terms are discussed further, the “*” denotes terminology from the ARIA guidelines. Seasonal: Symptoms occur during one or more seasons of the year. Generally caused by one or more outdoor allergens, typically pollens.

Stay updated, free articles. Join our Telegram channel

Join