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Allergic rhinitis: Clinical manifestations, epidemiology, and diagnosis

Authors
Richard D deShazo, MD
Stephen F Kemp, MD
Section Editor
Jonathan Corren, MD
Deputy Editor
Anna M Feldweg, MD

INTRODUCTION AND TERMINOLOGY

Allergic rhinitis, or allergic rhinosinusitis, is characterized by paroxysms of sneezing, rhinorrhea, and nasal obstruction, often accompanied by itching of the eyes, nose, and palate. Postnasal drip, cough, irritability, and fatigue are other common symptoms [1-3].

Some investigators prefer the term "rhinosinusitis" to the separate terms "rhinitis" and "sinusitis." This is because the nose and sinus mucosa are contiguous, rhinitis and sinusitis frequently occur together, rhinitis commonly leads to sinusitis, and nasal symptoms are common with sinusitis. However, within this topic review, rhinitis and sinusitis are referred to separately, given that management issues may differ for each condition, and detailed reviews of acute and chronic sinusitis are presented elsewhere. (See "Acute sinusitis and rhinosinusitis in adults: Clinical manifestations and diagnosis" and "Chronic rhinosinusitis: Clinical manifestations, pathophysiology, and diagnosis" and "Uncomplicated acute sinusitis and rhinosinusitis in adults: Treatment".)

The clinical manifestations, epidemiology, and diagnosis of allergic rhinitis are presented in this topic review. The pathogenesis and treatment of this condition are discussed separately. (See "Pathogenesis of allergic rhinitis (rhinosinusitis)" and "Pharmacotherapy of allergic rhinitis".)

EPIDEMIOLOGY

Allergic rhinitis is common, affecting 10 to 30 percent of children and adults in the United States and other industrialized countries [4-9]. It may be less common in some parts of the world, although even developing countries report significant rates [10-16]. The prevalence of asthma, rhinoconjunctivitis, and eczema were systematically evaluated in approximately 1.2 million children in 98 countries in the International Study of Asthma and Allergies in Childhood (ISAAC) [17]. The overall prevalence of rhinoconjunctivitis in children aged 6 to 7 years and 13 to 14 years was 8.5 and 14.6 percent, respectively.

The prevalence in the industrialized world is increasing, particularly in urban areas [18-20]. Theories about the reasons for increasing prevalence are reviewed separately. (See "Increasing prevalence of asthma and allergic rhinitis and the role of environmental factors".)

                            

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