Diagnosis and treatment of allergic rhinitis

Young Hoon Kim; Kyung-Su Kim

doi:10.5124/jkma.2010.53.9.780

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Kim and Kim: Diagnosis and treatment of allergic rhinitis

Continuing Education Column

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2010; 53(9): 780-790.

Published online: 7 September 2010

DOI: https://doi.org/10.5124/jkma.2010.53.9.780

Diagnosis and treatment of allergic rhinitis

Young Hoon Kim, MD, Kyung-Su Kim, MD

Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author: Kyung-Su Kim, ydrhinol@yuhs.ac

Received 7 July 2010 Accepted 21 July 2010

(open-access):

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Allergic rhinitis (AR) is a global health problem affecting at least 10 to 25% of the population, and is a chronic respiratory illness that affects quality of life, productivity, and other co-morbid conditions such as asthma and sinusitis. Classification of AR has been changed to intermittent/persistent (duration) and mild/moderate-severe (severity) based on the "Allergic Rhinitis and Its Impact on Asthma" (ARIA) workshop report published in 2001. A patient's history and skin prick test results are of utmost importance for its diagnosis regardless of classification system. Treatment should be based on the patient's age, severity, and duration of symptoms. The treatment algorithm has recently been revised by 2008 ARIA guidelines. Treatment options for AR consist of allergen avoidance, pharmacotherapy, immunotherapy, and surgery. Patients should be advised to avoid known allergens and educate themselves about their condition. Although allergen avoidance and immunotherapy are theoretically ideal, intranasal corticosteroids are the most effective treatment in persistent and moderate-severe AR. Sublingual immunotherapy has been introduced and has shown good results in its efficacy and safety. Physicians are advised to be alert to the state-of-the-art knowledge on AR and be willing to take advantage of recent progress on AR.

Keywords: Allergic rhinitis, Skin test, Immunotherapy

Figures and Tables

Figure 1

ARIA classification of severity of allergic rhinitis [4].

Figure 2

ARIA algorithm for treatment of allergic rhinitis [20].

Table 1

Differential diagnosis of rhinitis

Table 2

Allergic vs. Non-allergic rhinitis

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