Rhinitis

Common disease involving acute or chronic inflammation of the nasal mucosa

Aetiology

  • Allergic - allergen
  • Non-allergic - infection, hormonal imbalance, medications etc.
  • Mixed

Pathophysiology

Allergic rhinitis

  1. Inhalation of allergen increases specific IgE levels
  1. IgE binds to receptors on mast cells and basophils
  1. Re-exposure to allergen causes degranulation of mast cells and basophils → release of inflammatory mediators e.g. histamine
  1. This causes acute rhinorrhoea, itching and sneezing
  1. Recruitment of lymphocytes and eosinophils causes the delayed response

Non-allergic rhinitis

  • Any rhinitis that does not involve IgE e.g. viral infection

Clinical presentation

  • Rhinorrhoea (‘runny nose)
  • Sneezing
  • Itching
  • Nasal congestion and obstruction

Management of allergic rhinitis

  • Glucocorticoids
  • Antihistamines
  • Muscarinic receptor antagonists
  • Cysteinyl leukotriene receptor antagonists
  • Vasoconstrictors