Allergic rhinitis diagnosis

Table 23.1 Differential diagnosis of hayfever (allergic rhinitis) and the common cold...

Secondary prevention is also covered in some detail since adequate diagnosis and treatment of allergic diseases such as eczema and allergic rhinitis at a young age can prevent the later development of asthma. 

Nasal scrapings will provide a representative sample of cells infiltrating the nasal mucosa and can be helpful in supporting the diagnosis. Microscopic examination of the nasal smear from an allergic individual typically will show numerous eosinophils. The blood eosinophil count may be elevated in allergic rhinitis, but it is nonspecific and has limited usefulness. ... 

Skoner DP. Allergic rhinitis Definition, epidemiology, pathophysiology, detection, and diagnosis. J Allergy Clin Immunol 2001 8 S2-S8. 

Because of the bronchial muscle relaxant effect, caffeine is used in chronic obstructive pulmonary disease and for the treatment of asthma. The use of caffeine in the treatment of children with minimal brain dysfunction, to increase the duration of electroconvulsive therapy-induced seizure, for allergic rhinitis, as well as for atopic dermatitis has also been described. Recently, caffeine has been used as a diagnostic test for malignant hyperthermia and in the diagnosis of neuroleptic malignant syndrome, a complication of neuroleptic therapy. 

A nasal smear rich in eosinophils suggests the diagnosis of allergic rhinitis, but it may be only 60% sensitive (48), and it is not specific because eosinophilia is also found in patients with nasal polyps and nonallergic rhinitis with eosinophilia syndrome (NARES) (49). Frequently, however, nasal smears may be used to help differentiate between these forms of rhinitis and infectious rhinitis in which neutrophils predominate. 

In the differential diagnosis of allergic rhinitis, one should include the following rhinitides vasomotor rhinitis, nonallergic rhinitis with eosinophilia syndrome (NARES) (49), atrophic rhinitis (52), occupational rhinitis, medication-induced rhinitis (especially rhinitis medicamentosa due to the overuse of topical sympa-thomimetics), hormonal rhinitis (pregnancy and hypothyroidism), infectious rhi-... 

AD is a chronic inflammatory skin disorder conunonly associated with allergic rhinitis and asthma (1). The diagnosis of AD is based on clinical criteria first described by Hanifin and Rajka (2). The major features include pruritus, typical morphology and distribution of the skin lesions, and a chronic relapsing course. 

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