The Experts below are selected from a list of 107736 Experts worldwide ranked by ideXlab platform
Jean Bousquet - One of the best experts on this subject based on the ideXlab platform.
-
The influence of allergic Rhinitis on asthma
Ugeskrift for laeger, 2009Co-Authors: Ronald Dahl, Hans-jørgen Malling, Lars Peter Nielsen, Nikolai Khaltaev, Jean BousquetAbstract:Allergic Rhinitis presents as intermittent or persistent nasal symptoms with sneeze, blockage and secretions. Rhinitis affects more that 20% of the population and is more frequent in younger persons. Allergic Rhinitis influences all aspects of quality of life, school performance and work. Most asthmatics suffer from Rhinitis and many Rhinitis patients suffer from asthma. Patients with Rhinitis should be evaluated for asthma and patients with asthma should be evaluated for Rhinitis. A combined strategy should be applied in the treatment of upper and lower airways.
-
Rhinitis and onset of asthma a longitudinal population based study
The Lancet, 2008Co-Authors: Rafea Shaaban, Catherine Neukirch, Mahmoud Zureik, D Soussan, Joachim Heinrich, Jordi Sunyer, Matthias Wjst, Isa Cerveri, Isabelle Pin, Jean BousquetAbstract:BACKGROUND: A close relation between asthma and allergic Rhinitis has been reported by several epidemiological and clinical studies. However, the nature of this relation remains unclear. We used the follow-up data from the European Community Respiratory Health Survey to investigate the onset of asthma in patients with allergic and non-allergic Rhinitis during an 8.8-year period. METHODS: We did a longitudinal population-based study, which included 29 centres (14 countries) mostly in western Europe. Frequency of asthma was studied in 6461 participants, aged 20-44 years, without asthma at baseline. Incident asthma was defined as reporting ever having had asthma confirmed by a physician between the two surveys. Atopy was defined as a positive skin-prick test to mites, cat, Alternaria, Cladosporium, grass, birch, Parietaria, olive, or ragweed. Participants were classified into four groups at baseline: controls (no atopy, no Rhinitis; n=3163), atopy only (atopy, no Rhinitis; n=704), non-allergic Rhinitis (Rhinitis, no atopy; n=1377), and allergic Rhinitis (atopy+Rhinitis; n=1217). Cox proportional hazards models were used to study asthma onset in the four groups. FINDINGS: The 8.8-year cumulative incidence of asthma was 2.2% (140 events), and was different in the four groups (1.1% (36), 1.9% (13), 3.1% (42), and 4.0% (49), respectively; p<0.0001). After controlling for country, sex, baseline age, body-mass index, forced expiratory volume in 1 s (FEV(1)), log total IgE, family history of asthma, and smoking, the adjusted relative risk for asthma was 1.63 (95% CI 0.82-3.24) for atopy only, 2.71 (1.64-4.46) for non-allergic Rhinitis, and 3.53 (2.11-5.91) for allergic Rhinitis. Only allergic Rhinitis with sensitisation to mite was associated with increased risk of asthma independently of other allergens (2.79 [1.57-4.96]). INTERPRETATION: Rhinitis, even in the absence of atopy, is a powerful predictor of adult-onset asthma.
-
original article visual analog scales can assess the severity of Rhinitis graded according to aria guidelines
Allergy, 2007Co-Authors: P J Bousquet, F Neukirch, Jean Michel Klossek, C Combescure, H Mechin, Jeanpierre Daures, Jean BousquetAbstract:Background: The allergic Rhinitis and its impact on asthma (ARIA) guidelines provide a new classification of allergic Rhinitis, but a quantitative analysis for severity assessment is lacking. Objective: To study whether a visual analog scale (VAS) for global Rhinitis symptoms could be used to assess the disease severity according to ARIA. Methods: Three thousand fifty-two allergic Rhinitis patients seen in primary care were tested. Fifty three per cent had an objective diagnosis of allergy and 58% of the patients were treated. Patients were categorized according to ARIA guidelines. The severity of nasal symptoms was assessed using a VAS. Quality of life was measured using the rhinoconjunctivitis quality of life questionnaire (RQLQ). Results: Severity had more impact on VAS levels than duration: mild intermittent Rhinitis (3.5, 2.4–5.0 cm), mild persistent Rhinitis (4.5, 3.2–5.6 cm), moderate/severe intermittent Rhinitis (6.7, 5.3–7.7 cm) and moderate/severe persistent Rhinitis (7.2, 6.1–8.2 cm). The receiver operating characteristic curve results showed that patients with a VAS of under 5 cm could be classified as ‘mild’ Rhinitis (negative predictive value: 93.5%) and those with a VAS of over 6 cm as ‘moderate/severe’ Rhinitis (positive predictive value: 73.6%). Receiver operating characteristic curves and a logistic regression showed that current treatment and allergy diagnosis have no effect on the assessment of Rhinitis severity using VAS. Visual analog scale and the RQLQ global score were significantly correlated (ρ = 0.46; P < 0.0001). Conclusion: A simple and quantitative method (VAS) can be used for the quantitative evaluation of severity of allergic Rhinitis.
-
severity and impairment of allergic Rhinitis in patients consulting in primary care
The Journal of Allergy and Clinical Immunology, 2006Co-Authors: Jean Bousquet, F Neukirch, P J Bousquet, Pierre Gehano, Jean Michel Klossek, Martine Le Gal, Bashar AllafAbstract:Background Allergic Rhinitis is a disease impairing quality of life, sleep, and work. A new classification for allergic Rhinitis, Allergic Rhinitis and its Impact on Asthma (ARIA), has recently been proposed. Objective To study the effect of allergic Rhinitis using ARIA definitions to determine severity and duration. Methods A total of 3052 patients consulting general practitioners for allergic Rhinitis were studied. Patients were classified according to the 4 classes of ARIA. In all patients, quality of life (Rhinoconjunctivitis Quality-of-Life Questionnaire), sleep (Jenkins questionnaire), and work performance (Allergy-Specific Work Productivity and Activity Impairment questionnaire) were assessed. Results Mild intermittent Rhinitis was diagnosed in 11% of the patients, mild persistent Rhinitis in 8%, moderate/severe intermittent Rhinitis in 35%, and moderate/severe persistent Rhinitis in 46%. The severity of Rhinitis has more of an effect on quality of life, sleep, daily activities, and work performance than the duration of Rhinitis. In moderate/severe Rhinitis, more than 80% of patients report impaired activities, as opposed to only 40% with mild Rhinitis. Conclusion It seems that the term moderate/severe should be replaced by severe . A study in the general population is necessary, however, to assess the prevalence of the 4 ARIA classes of allergic Rhinitis, especially in patients who are not consulting physicians for their symptoms.
-
association between asthma and Rhinitis according to atopic sensitization in a population based study
The Journal of Allergy and Clinical Immunology, 2004Co-Authors: Benedicte Leynaert, Jean Bousquet, Catherine Neukirch, Sabine Kony, Armelle Guenegou, M Aubier, F NeukirchAbstract:Abstract Background Although asthma and Rhinitis often occur together, the reason for this common comorbidity is still a matter of debate. Objective We sought to assess whether the coexistence of asthma and Rhinitis could be explained by common risk factors. Methods International cross-sectional study of representative samples of young adults, who completed a detailed questionnaire and underwent lung function tests, bronchoprovocation challenge, IgE measurements, and skin prick tests. Results In all countries, asthma and bronchial hyperreactivity were more frequent in subjects with Rhinitis than in those without (odds ratio [OR], 6.63; 95% CI, 5.44-8.08; and OR, 3.02 95% CI, 2.66-3.43, respectively). Seventy-four percent to 81% of subjects with asthma reported Rhinitis, depending on sensitization to specific allergens. Conversely, the risk of asthma increased from 2.0% in subjects without Rhinitis to 6.7% in subjects with Rhinitis only when exposed to pollen, 11.9% in subjects with Rhinitis when exposed to animals, and 18.8% in subjects with Rhinitis either when exposed to pollen or to animals. The association between Rhinitis and asthma remained significant after adjustment for total IgE, parental history of asthma, and allergen sensitization (OR, 3.41; 95% CI, 2.75-4.2 suggesting that the coexistence of asthma and Rhinitis is not solely due to atopic predisposition to these 2 diseases. Conclusions Although there were some variations in the association between asthma and Rhinitis according to sensitization to individual allergens, the strong association between asthma and Rhinitis was not fully explained by shared risk factors, including atopy. Our findings are consistent with the hypothesis that Rhinitis might increase the risk of asthma.
F Neukirch - One of the best experts on this subject based on the ideXlab platform.
-
original article visual analog scales can assess the severity of Rhinitis graded according to aria guidelines
Allergy, 2007Co-Authors: P J Bousquet, F Neukirch, Jean Michel Klossek, C Combescure, H Mechin, Jeanpierre Daures, Jean BousquetAbstract:Background: The allergic Rhinitis and its impact on asthma (ARIA) guidelines provide a new classification of allergic Rhinitis, but a quantitative analysis for severity assessment is lacking. Objective: To study whether a visual analog scale (VAS) for global Rhinitis symptoms could be used to assess the disease severity according to ARIA. Methods: Three thousand fifty-two allergic Rhinitis patients seen in primary care were tested. Fifty three per cent had an objective diagnosis of allergy and 58% of the patients were treated. Patients were categorized according to ARIA guidelines. The severity of nasal symptoms was assessed using a VAS. Quality of life was measured using the rhinoconjunctivitis quality of life questionnaire (RQLQ). Results: Severity had more impact on VAS levels than duration: mild intermittent Rhinitis (3.5, 2.4–5.0 cm), mild persistent Rhinitis (4.5, 3.2–5.6 cm), moderate/severe intermittent Rhinitis (6.7, 5.3–7.7 cm) and moderate/severe persistent Rhinitis (7.2, 6.1–8.2 cm). The receiver operating characteristic curve results showed that patients with a VAS of under 5 cm could be classified as ‘mild’ Rhinitis (negative predictive value: 93.5%) and those with a VAS of over 6 cm as ‘moderate/severe’ Rhinitis (positive predictive value: 73.6%). Receiver operating characteristic curves and a logistic regression showed that current treatment and allergy diagnosis have no effect on the assessment of Rhinitis severity using VAS. Visual analog scale and the RQLQ global score were significantly correlated (ρ = 0.46; P < 0.0001). Conclusion: A simple and quantitative method (VAS) can be used for the quantitative evaluation of severity of allergic Rhinitis.
-
severity and impairment of allergic Rhinitis in patients consulting in primary care
The Journal of Allergy and Clinical Immunology, 2006Co-Authors: Jean Bousquet, F Neukirch, P J Bousquet, Pierre Gehano, Jean Michel Klossek, Martine Le Gal, Bashar AllafAbstract:Background Allergic Rhinitis is a disease impairing quality of life, sleep, and work. A new classification for allergic Rhinitis, Allergic Rhinitis and its Impact on Asthma (ARIA), has recently been proposed. Objective To study the effect of allergic Rhinitis using ARIA definitions to determine severity and duration. Methods A total of 3052 patients consulting general practitioners for allergic Rhinitis were studied. Patients were classified according to the 4 classes of ARIA. In all patients, quality of life (Rhinoconjunctivitis Quality-of-Life Questionnaire), sleep (Jenkins questionnaire), and work performance (Allergy-Specific Work Productivity and Activity Impairment questionnaire) were assessed. Results Mild intermittent Rhinitis was diagnosed in 11% of the patients, mild persistent Rhinitis in 8%, moderate/severe intermittent Rhinitis in 35%, and moderate/severe persistent Rhinitis in 46%. The severity of Rhinitis has more of an effect on quality of life, sleep, daily activities, and work performance than the duration of Rhinitis. In moderate/severe Rhinitis, more than 80% of patients report impaired activities, as opposed to only 40% with mild Rhinitis. Conclusion It seems that the term moderate/severe should be replaced by severe . A study in the general population is necessary, however, to assess the prevalence of the 4 ARIA classes of allergic Rhinitis, especially in patients who are not consulting physicians for their symptoms.
-
association between asthma and Rhinitis according to atopic sensitization in a population based study
The Journal of Allergy and Clinical Immunology, 2004Co-Authors: Benedicte Leynaert, Jean Bousquet, Catherine Neukirch, Sabine Kony, Armelle Guenegou, M Aubier, F NeukirchAbstract:Abstract Background Although asthma and Rhinitis often occur together, the reason for this common comorbidity is still a matter of debate. Objective We sought to assess whether the coexistence of asthma and Rhinitis could be explained by common risk factors. Methods International cross-sectional study of representative samples of young adults, who completed a detailed questionnaire and underwent lung function tests, bronchoprovocation challenge, IgE measurements, and skin prick tests. Results In all countries, asthma and bronchial hyperreactivity were more frequent in subjects with Rhinitis than in those without (odds ratio [OR], 6.63; 95% CI, 5.44-8.08; and OR, 3.02 95% CI, 2.66-3.43, respectively). Seventy-four percent to 81% of subjects with asthma reported Rhinitis, depending on sensitization to specific allergens. Conversely, the risk of asthma increased from 2.0% in subjects without Rhinitis to 6.7% in subjects with Rhinitis only when exposed to pollen, 11.9% in subjects with Rhinitis when exposed to animals, and 18.8% in subjects with Rhinitis either when exposed to pollen or to animals. The association between Rhinitis and asthma remained significant after adjustment for total IgE, parental history of asthma, and allergen sensitization (OR, 3.41; 95% CI, 2.75-4.2 suggesting that the coexistence of asthma and Rhinitis is not solely due to atopic predisposition to these 2 diseases. Conclusions Although there were some variations in the association between asthma and Rhinitis according to sensitization to individual allergens, the strong association between asthma and Rhinitis was not fully explained by shared risk factors, including atopy. Our findings are consistent with the hypothesis that Rhinitis might increase the risk of asthma.
-
epidemiologic evidence for asthma and Rhinitis comorbidity
The Journal of Allergy and Clinical Immunology, 2000Co-Authors: Benedicte Leynaert, F Neukirch, P Demoly, Jean BousquetAbstract:Asthma and Rhinitis are often comorbid conditions, and the overall characteristics of the diseases and the treatment options for the disorders are similar. Several recent epidemiologic studies in the general population have provided evidence to strongly associate the development of asthma with a previous history of either allergic or perennial Rhinitis. Additional links between asthma and Rhinitis include a description of increased aspirin intolerance in both disorders and the observation that most subjects with occupational asthma experience Rhinitis. Further, the likelihood of the development of asthma is much higher in individuals with both perennial and seasonal Rhinitis than for individuals with either condition alone. Asthma and Rhinitis were found to be comorbidities regardless of atopic state, and perennial Rhinitis has been associated with an increase in nonspecific bronchial hyperresponsiveness. Several studies have identified Rhinitis as a risk factor for asthma, with the prevalence of allergic Rhinitis in asthmatic patients being 80% to 90%. These studies and others demonstrate that the coexistence of asthma and allergic Rhinitis is frequent, that allergic Rhinitis usually precedes asthma, and that allergic Rhinitis is a risk factor for asthma. Finally, studies that have examined the age of onset of atopy as a confounding factor for the development of asthma and allergic Rhinitis have suggested that early age atopy may be an important predictive factor for respiratory symptoms that continue into late childhood. In conclusion, Rhinitis and asthma are strongly associated, and Rhinitis has been identified as a risk factor for asthma.
-
quality of life in allergic Rhinitis and asthma a population based study of young adults
American Journal of Respiratory and Critical Care Medicine, 2000Co-Authors: Benedicte Leynaert, Jean Bousquet, Catherine Neukirch, Renata Liard, F NeukirchAbstract:Quality of life has been found to be impaired both in patients with asthma and in patients with allergic Rhinitis, but the relative burden of these diseases has not been investigated. We analyzed answers to the SF-36 questionnaire from 850 subjects recruited in two French centers participating in the European Community Respiratory Health Survey, a population-based study of young adults. Both asthma and allergic Rhinitis were associated with an impairment in quality of life. However, 78% of asthmatics also had allergic Rhinitis. Subjects with allergic Rhinitis but not asthma (n = 240) were more likely than subjects with neither asthma nor Rhinitis (n = 349) to report problems with social activities, difficulties with daily activities as a result of emotional problems, and poorer mental well-being. Patients with both asthma and allergic Rhinitis (n = 76) experienced more physical limitations than patients with allergic Rhinitis alone, but no difference was found between these two groups for concepts related to social/mental health. As asthma was not found to further impair the quality of life in subjects with allergic Rhinitis for concepts related to mental disability and well-being, and as subjects with asthma often also suffer from allergic Rhinitis, further studies on quality of life in asthma should ensure that the impairment in quality of life attributed to asthma could not result from concomitant allergic Rhinitis.
C Bachert - One of the best experts on this subject based on the ideXlab platform.
-
Persistent Rhinitis – allergic or nonallergic?
Allergy, 2004Co-Authors: C BachertAbstract:Although Rhinitis has been classified as being either allergic, noninfectious, or other forms (nonallergic noninfectious), these categories lack strict classification criteria and often overlap. The term nonallergic noninfectious Rhinitis is commonly applied to a diagnosis of any nasal condition, in which the symptoms are similar to those seen in allergic Rhinitis but an allergic aetiology has been excluded. This group comprises several subgroups with ill-defined pathomechanisms, and includes idiopathic Rhinitis, irritative-toxic (occupational) Rhinitis, hormonal Rhinitis, drug-induced Rhinitis, and other forms (non-allergic Rhinitis with eosinophilia syndrome [HARES], Rhinitis due to physical and chemical factors, food-induced Rhinitis, emotion-induced Rhinitis, atrophic Rhinitis). Unlike allergic Rhinitis, there are no specific diagnostic tests and diagnosis is primarily based on a history of reaction to specific irritant-toxic triggering agents (either general or occupational), drugs, infections, and hormonal status, coupled with exclusion of allergic Rhinitis and other forms of non-allergic Rhinitis by skin prick testing. Accordingly, from a clinical standpoint NARES, irritative-toxic, hormonal, drug-induced and idiopathic Rhinitis are possibly the least difficult forms of nonallergic Rhinitis to diagnose.
-
Persistent Rhinitis - allergic or nonallergic?
Allergy, 2004Co-Authors: C BachertAbstract:Although Rhinitis has been classified as being either allergic, noninfectious, or "other forms" (nonallergic noninfectious), these categories lack strict classification criteria and often overlap. The term "nonallergic noninfectious Rhinitis" is commonly applied to a diagnosis of any nasal condition, in which the symptoms are similar to those seen in allergic Rhinitis but an allergic aetiology has been excluded. This group comprises several subgroups with ill-defined pathomechanisms, and includes idiopathic Rhinitis, irritative-toxic (occupational) Rhinitis, hormonal Rhinitis, drug-induced Rhinitis, and other forms (non-allergic Rhinitis with eosinophilia syndrome [NARES], Rhinitis due to physical and chemical factors, food-induced Rhinitis, emotion-induced Rhinitis, atrophic Rhinitis). Unlike allergic Rhinitis, there are no specific diagnostic tests and diagnosis is primarily based on a history of reaction to specific irritant-toxic triggering agents (either general or occupational), drugs, infections, and hormonal status, coupled with exclusion of allergic Rhinitis and other forms of non-allergic Rhinitis by skin prick testing. Accordingly, from a clinical standpoint NARES, irritative-toxic, hormonal, drug-induced and idiopathic Rhinitis are possibly the least difficult forms of nonallergic Rhinitis to diagnose.
Benedicte Leynaert - One of the best experts on this subject based on the ideXlab platform.
-
association between asthma and Rhinitis according to atopic sensitization in a population based study
The Journal of Allergy and Clinical Immunology, 2004Co-Authors: Benedicte Leynaert, Jean Bousquet, Catherine Neukirch, Sabine Kony, Armelle Guenegou, M Aubier, F NeukirchAbstract:Abstract Background Although asthma and Rhinitis often occur together, the reason for this common comorbidity is still a matter of debate. Objective We sought to assess whether the coexistence of asthma and Rhinitis could be explained by common risk factors. Methods International cross-sectional study of representative samples of young adults, who completed a detailed questionnaire and underwent lung function tests, bronchoprovocation challenge, IgE measurements, and skin prick tests. Results In all countries, asthma and bronchial hyperreactivity were more frequent in subjects with Rhinitis than in those without (odds ratio [OR], 6.63; 95% CI, 5.44-8.08; and OR, 3.02 95% CI, 2.66-3.43, respectively). Seventy-four percent to 81% of subjects with asthma reported Rhinitis, depending on sensitization to specific allergens. Conversely, the risk of asthma increased from 2.0% in subjects without Rhinitis to 6.7% in subjects with Rhinitis only when exposed to pollen, 11.9% in subjects with Rhinitis when exposed to animals, and 18.8% in subjects with Rhinitis either when exposed to pollen or to animals. The association between Rhinitis and asthma remained significant after adjustment for total IgE, parental history of asthma, and allergen sensitization (OR, 3.41; 95% CI, 2.75-4.2 suggesting that the coexistence of asthma and Rhinitis is not solely due to atopic predisposition to these 2 diseases. Conclusions Although there were some variations in the association between asthma and Rhinitis according to sensitization to individual allergens, the strong association between asthma and Rhinitis was not fully explained by shared risk factors, including atopy. Our findings are consistent with the hypothesis that Rhinitis might increase the risk of asthma.
-
epidemiologic evidence for asthma and Rhinitis comorbidity
The Journal of Allergy and Clinical Immunology, 2000Co-Authors: Benedicte Leynaert, F Neukirch, P Demoly, Jean BousquetAbstract:Asthma and Rhinitis are often comorbid conditions, and the overall characteristics of the diseases and the treatment options for the disorders are similar. Several recent epidemiologic studies in the general population have provided evidence to strongly associate the development of asthma with a previous history of either allergic or perennial Rhinitis. Additional links between asthma and Rhinitis include a description of increased aspirin intolerance in both disorders and the observation that most subjects with occupational asthma experience Rhinitis. Further, the likelihood of the development of asthma is much higher in individuals with both perennial and seasonal Rhinitis than for individuals with either condition alone. Asthma and Rhinitis were found to be comorbidities regardless of atopic state, and perennial Rhinitis has been associated with an increase in nonspecific bronchial hyperresponsiveness. Several studies have identified Rhinitis as a risk factor for asthma, with the prevalence of allergic Rhinitis in asthmatic patients being 80% to 90%. These studies and others demonstrate that the coexistence of asthma and allergic Rhinitis is frequent, that allergic Rhinitis usually precedes asthma, and that allergic Rhinitis is a risk factor for asthma. Finally, studies that have examined the age of onset of atopy as a confounding factor for the development of asthma and allergic Rhinitis have suggested that early age atopy may be an important predictive factor for respiratory symptoms that continue into late childhood. In conclusion, Rhinitis and asthma are strongly associated, and Rhinitis has been identified as a risk factor for asthma.
-
quality of life in allergic Rhinitis and asthma a population based study of young adults
American Journal of Respiratory and Critical Care Medicine, 2000Co-Authors: Benedicte Leynaert, Jean Bousquet, Catherine Neukirch, Renata Liard, F NeukirchAbstract:Quality of life has been found to be impaired both in patients with asthma and in patients with allergic Rhinitis, but the relative burden of these diseases has not been investigated. We analyzed answers to the SF-36 questionnaire from 850 subjects recruited in two French centers participating in the European Community Respiratory Health Survey, a population-based study of young adults. Both asthma and allergic Rhinitis were associated with an impairment in quality of life. However, 78% of asthmatics also had allergic Rhinitis. Subjects with allergic Rhinitis but not asthma (n = 240) were more likely than subjects with neither asthma nor Rhinitis (n = 349) to report problems with social activities, difficulties with daily activities as a result of emotional problems, and poorer mental well-being. Patients with both asthma and allergic Rhinitis (n = 76) experienced more physical limitations than patients with allergic Rhinitis alone, but no difference was found between these two groups for concepts related to social/mental health. As asthma was not found to further impair the quality of life in subjects with allergic Rhinitis for concepts related to mental disability and well-being, and as subjects with asthma often also suffer from allergic Rhinitis, further studies on quality of life in asthma should ensure that the impairment in quality of life attributed to asthma could not result from concomitant allergic Rhinitis.
Russell A. Settipane - One of the best experts on this subject based on the ideXlab platform.
-
Chapter 14: Nonallergic Rhinitis.
American journal of rhinology & allergy, 2013Co-Authors: Russell A. Settipane, Michael A. KalinerAbstract:Rhinitis is characterized by one or more of the following nasal symptoms: congestion, rhinorrhea (anterior and posterior), sneezing, and itching. It is classified as allergic or nonallergic, the latter being a diverse syndrome that is characterized by symptoms of Rhinitis that are not the result of IgE-mediated events. Excluding infectious Rhinitis and underlying systemic diseases, clinical entities that can be classified among the disorders that make up the nonallergic Rhinitis syndromes include gustatory Rhinitis, nonallergic Rhinitis with eosinophilia syndrome (NARES), atrophic, drug-induced (Rhinitis medicamentosa), hormone induced, senile Rhinitis (of the elderly), Rhinitis associated with chronic rhinosinusitis with or without nasal polyps, and the idiopathic variant formerly known as vasomotor Rhinitis but more accurately denoted as nonallergic rhinopathy (NAR). The prevalence of nonallergic Rhinitis has been observed to be one-third that of allergic Rhinitis, affecting ~7% of the U.S. population or ~22 million people. NAR is the most common of the nonallergic Rhinitis subtypes, comprising at least two-thirds of all nonallergic Rhinitis sufferers. Although certain precipitants such as perfume, strong odors, changes in temperature or humidity, and exposure to tobacco smoke are frequently identified as symptom triggers, NAR may occur in the absence of defined triggers. The diagnosis of nonallergic Rhinitis is purely clinical and relies on a detailed history and physical exam. Skin testing or in vitro testing to seasonal and perennial aeroallergens is required to make the diagnosis of nonallergic Rhinitis. Because of the heterogeneous nature of this group of disorders, treatment should be individualized to the patient's underlying pathophysiology and/or symptoms and is often empiric.
-
Other Causes of Rhinitis: Mixed Rhinitis, Rhinitis Medicamentosa, Hormonal Rhinitis, Rhinitis of the Elderly, and Gustatory Rhinitis
Immunology and allergy clinics of North America, 2011Co-Authors: Russell A. SettipaneAbstract:It is important to consider a comprehensive differential of possible Rhinitis types when considering the diagnosis of chronic Rhinitis, including at least 9 subtypes of nonallergic Rhinitis: drug-induced Rhinitis, gustatory Rhinitis, hormonal-induced Rhinitis, infectious Rhinitis, nonallergic Rhinitis with eosinophilia syndrome, occupational Rhinitis, senile Rhinitis, atrophic Rhinitis, and nonallergic rhinopathy. This article focuses on some of the most common types of chronic Rhinitis, including mixed Rhinitis (allergic and nonallergic overlap), Rhinitis medicamentosa, hormonal Rhinitis, Rhinitis of the elderly, and gustatory Rhinitis.
-
Epidemiology of vasomotor Rhinitis.
World Allergy Organization Journal, 2009Co-Authors: Russell A. SettipaneAbstract:Vasomotor Rhinitis is the most common form of nonallergic Rhinitis, comprising approximately 71% of all nonallergic Rhinitis conditions. Although the epidemiology of this subtype of nonallergic Rhinitis has not been definitively studied, it is estimated that 14 million Americans suffer from vasomotor Rhinitis, with a worldwide prevalence approaching 320 million.
-
Epidemiology of Rhinitis: allergic and nonallergic.
Clinical allergy and immunology, 2007Co-Authors: Russell A. Settipane, David R CharnockAbstract:In summary, the epidemiological data and characterization of allergic and nonallergic Rhinitis has been reviewed. Chronic Rhinitis symptoms are among the most common problems presenting to physicians. When approaching this problem the diagnostic challenge is to determine the etiology, specifically whether it is allergic, nonallergic, or perhaps an overlap of both conditions. Estimates of the prevalence of allergic Rhinitis range from as low as 9% to as high as 42%. Although the prevalence of nonallergic Rhinitis has not been studied definitively, it appears to be very common with an estimated prevalence in the United States of approximately 19 million. In comparison, the prevalence of mixed Rhinitis is approximately 26 million, and allergic Rhinitis ("pure" and "mixed" combined) 58 million. Challenges in the differential diagnosis of Rhinitis result from two major factors. Not only are presenting symptoms of allergic, nonallergic, and mixed Rhinitis often indistinguishable from one another, but also the differential diagnosis of nonallergic Rhinitis is extensive. Nonallergic Rhinitis is often characterized by onset after age 20, female predominance, nasal hyperactivity, perennial symptoms, and nasal eosinophilia in approximately one-third of the population. Positive tests for relevant specific IgE sensitivity in the setting of Rhinitis do not rule out "mixed Rhinitis" and may not rule out nonallergic Rhinitis. The significance of symptom exacerbation by nonallergic triggers in the setting of allergic Rhinitis remains to be determined. Goals for the future include reaching a consensus on the definitions of Rhinitis and Rhinitis subtypes including the establishment of mixed Rhinitis, updating guidelines for the interpretation of nonrelevant positive tests for specific IgE sensitivity, and reaching agreement on the nonallergic triggers that best define VMR or VMR subtypes. Only then can the most applicable research results be obtained. The desired result is the delivery of the most appropriate treatment, specifically tailored to the accurate diagnosis of patients with Rhinitis.
-
Rhinitis: a dose of epidemiological reality.
Allergy and asthma proceedings, 2003Co-Authors: Russell A. SettipaneAbstract:In the wide spectrum of medical practice, Rhinitis is often incorrectly assumed to be solely allergic in etiology. Consequently, other Rhinitis subtypes (nonallergic and mixed) remain under-diagnosed. This is of concern because inaccurate diagnosis may lead to unsatisfactory treatment outcome. Contributing to this under-diagnosis is the fact that primary care practitioners do not often have at their disposal the same diagnostic tools as the allergist. Tools that the allergist is more likely to use include nasal cytology, skin testing and in vitro assays for specific immunoglobulin E. Patients with pure nonallergic Rhinitis have negative skin tests or clinically irrelevant positive results. Mixed Rhinitis refers to the presence of both allergic and nonallergic Rhinitis components within the same individual. Allergic Rhinitis more commonly develops before the age of 20, whereas nonallergic Rhinitis affects an older population and disproportionately more females. The type of nasal symptoms manifested by the patient usually does not differentiate allergic from nonallergic Rhinitis. Vasomotor Rhinitis is the most common form of nonallergic Rhinitis, followed by nonallergic Rhinitis with eosinophilia and others. In terms of estimated prevalence, allergic Rhinitis affects approximately 58 million Americans, 19 million have pure nonallergic Rhinitis and 26 million have mixed Rhinitis. Thus a wide spectrum of relevant epidemiologic information can be used to assist in determining the differential diagnosis of Rhinitis. Physicians are reminded to look further and consider whether a Rhinitis patient truly has pure allergic Rhinitis or whether a diagnosis of mixed Rhinitis or nonallergic Rhinitis is more appropriate.
