Rhinitis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]
Overview
Natural History, Complications, Prognosis
Natural history
Rhinitis is a very common disease, and it is sometimes erroneously viewed as a trivial disease.[1][2] Allergic rhinitis rarely occurs in isolation, it is a product of a genetic predisposition, epigenetic events, and environmental exposures, and it is frequently associated with other forms of atopy such as eczema, asthma, and allergic eye disease(allergic rhinoconjunctivitis).[3][4][5] The vast majority of individuals with asthma have rhinitis, and allergic eye disease has been reported to affect almost all patients with allergic rhinitis.[3][6] Nonallergic rhinitis is also associated with asthma.[7][6] Frequent extension of rhinitis (especially infectious rhinitis) into the sinuses also occur, resulting in rhinosinusitis.[8][2] Children with nonallergic rhinitis have a higher likelihood of undergoing remission, compared with those with allergic rhinitis, who tend to have a more persistent disease.[7] Remission occurs in up to 73% of four year old children with nonallergic rhinitis by the age of eight years.[7] Rhinitis is a significant cause of lost school and work days, and it constitutes a huge financial burden to the society.[9][1] Untreated/poorly treated chronic rhinitis is associated with a diminished quality of life, disordered sleep, impaired work performance, and several other comorbidities.[2][4]
Complication
The complications of rhinitis include the following:[6][1][10]
- Conjuctivitis
- Rhinosinusitis
- Chronic cough- One of the commonest causes of chronic cough is posterior rhinorrhea(postnasal drip)
- Fatigue
- Mouth breathing
- Aggravation of adenoidal hypertrophy[11]
- Headache
- Poor sleep
- Snoring
- Cognitive impairment
- Hyperactivity
- Eustachian tube dysfunction
- Acute otitis media[11]
- Otitis media with effusion
- Aggravation of asthma
- Laryngitis[12]
Comorbidities associated with Allergic rhinitis include:[6]
- Allergic eye diseases[3]
- Seasonal allergic conjunctivitis
- Perennial allergic conjunctivitis
- Vernal keratoconjunctivitis
- Atopic keratoconjunctivitis
- Asthma- Allergic rhinitis is strongly associated with the risk of developing asthma, and the coexistence of rhinitis with asthma is often associated with an increase in asthma severity.[13]
- Atopic dermatitis
Prognosis
Resolution of allergic rhinitis occurs in only 10-20% of children within 10 years.[14] A higher likelihood of remission has been documented in children with nonallergic rhinitis compared to the allergic type, with remission occurring within four years in about 73% of four year old children suffering from nonallergic rhinitis. Poorly treated rhinitis is strongly associated with a decreased quality of life and several other comorbidities.
References
- ↑ 1.0 1.1 1.2 Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA; et al. (2008). "The diagnosis and management of rhinitis: an updated practice parameter". J Allergy Clin Immunol. 122 (2 Suppl): S1–84. doi:10.1016/j.jaci.2008.06.003. PMID 18662584.
- ↑ 2.0 2.1 2.2 Romeo, Jonathan; Dykewicz, Mark (2014). "Chapter 9:Differential Diagnosis of Rhinitis and Rhinosinusitis". Diseases of the Sinuses. Springer New York. pp. 133–152. ISBN 978-1-4939-0265-1.
- ↑ 3.0 3.1 3.2 Shaker M, Salcone E (2016). "An update on ocular allergy". Curr Opin Allergy Clin Immunol. 16 (5): 505–10. doi:10.1097/ACI.0000000000000299. PMID 27490123.
- ↑ 4.0 4.1 Sacre Hazouri JA (2006). "[Allergic rhinitis. Coexistent diseases and complications. A review and analysis]". Rev Alerg Mex. 53 (1): 9–29. PMID 16634358.
- ↑ Mims JW (2014). "Epidemiology of allergic rhinitis". Int Forum Allergy Rhinol. 4 Suppl 2: S18–20. doi:10.1002/alr.21385. PMID 25182349.
- ↑ 6.0 6.1 6.2 6.3 Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A; et al. (2008). "Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen)". Allergy. 63 Suppl 86: 8–160. doi:10.1111/j.1398-9995.2007.01620.x. PMID 18331513.
- ↑ 7.0 7.1 7.2 Westman M, Stjärne P, Asarnoj A, Kull I, van Hage M, Wickman M; et al. (2012). "Natural course and comorbidities of allergic and nonallergic rhinitis in children". J Allergy Clin Immunol. 129 (2): 403–8. doi:10.1016/j.jaci.2011.09.036. PMID 22056609.
- ↑ Dykewicz MS, Hamilos DL (2010). "Rhinitis and sinusitis". J Allergy Clin Immunol. 125 (2 Suppl 2): S103–15. doi:10.1016/j.jaci.2009.12.989. PMID 20176255.
- ↑ Schoenwetter WF, Dupclay L, Appajosyula S, Botteman MF, Pashos CL (2004). "Economic impact and quality-of-life burden of allergic rhinitis". Curr Med Res Opin. 20 (3): 305–17. doi:10.1185/030079903125003053. PMID 15025839.
- ↑ Blaiss MS (2008). "Pediatric allergic rhinitis: physical and mental complications". Allergy Asthma Proc. 29 (1): 1–6. doi:10.2500/aap2008.29.3072. PMID 18302831.
- ↑ 11.0 11.1 Sih T, Mion O (2010). "Allergic rhinitis in the child and associated comorbidities". Pediatr Allergy Immunol. 21 (1 Pt 2): e107–13. doi:10.1111/j.1399-3038.2009.00933.x. PMID 19664013.
- ↑ Turley R, Cohen SM, Becker A, Ebert CS (2011). "Role of rhinitis in laryngitis: another dimension of the unified airway". Ann Otol Rhinol Laryngol. 120 (8): 505–10. PMID 21922973.
- ↑ Deliu M, Belgrave D, Simpson A, Murray CS, Kerry G, Custovic A (2014). "Impact of rhinitis on asthma severity in school-age children". Allergy. 69 (11): 1515–21. doi:10.1111/all.12467. PMC 4209798. PMID 24958195.
- ↑ Sly RM (1999). "Changing prevalence of allergic rhinitis and asthma". Ann Allergy Asthma Immunol. 82 (3): 233–48, quiz 248-52. doi:10.1016/S1081-1206(10)62603-8. PMID 10094214.