Rhinoconjunctivitis

Allergic Seasonal or Perennial Rhinoconjunctivitis. Histamine can cause all pathologic features of allergic rhinitis (35—37), with the exception of late-phase inflammatory reactions. Pmritus is caused by stimulation of receptors on sensory nerve endings prostaglandins (qv) may also contribute. Sneering, like pmritus, is an H -mediated neural reflex and can also be mediated by eicosanoids. Mucosal edema, which manifests as nasal... 

Aspirin and NSAIDs can induce allergic and pseudoallergic reactions. Because these drugs are used so widely, with much over-the-counter use, the health care professional must have a basic understanding of the types of reactions that can occur and how to prevent them. Three types of reactions occur bron-chospasm with rhinoconjunctivitis, urticaria/angioedema, and anaphylaxis. Remember that patients with gastric discomfort... 

The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema ISAAC. Lancet 1998 351 1225-1232. 

The Medical Outcomes Study 36-Item Short Form Health Survey and the Rhinoconjunctivitis Quality of Life Questionnaire measure not only improvement in symptoms but also parameters such as sleep quality, nonallergic symptoms (e.g., fatigue, poor concentration), emotions, and participation in a variety of activities. 

Gautrin, D., Ghezzo, H., and Malo, J.L., Rhinoconjunctivitis, bronchial responsiveness, and atopy as determinants for incident non-work-related asthma symptoms in apprentices exposed to high-molecular-weight allergens, Allergy, 58, 608, 2003. 

Archambault, S. et al., Incidence of sensitization, symptoms, and probable occupational rhinoconjunctivitis and asthma in apprentices starting exposure to latex, J. Allergy Clin Immunol., 107, 921, 2001. 

Bernaola, G., Echechipia, S., Urrutia, I., Fernandez, E., Audicana, M., and Fernandez de Corres, L. (1994). Occupational asthma and rhinoconjunctivitis from inhalation of dried cow s milk caused by sensitization to alpha-lactalbumin. Allergy 49,189-191. 

Seasonal rhinoconjunctivitis (SRC). Inflammation of the mucus membranes of the nose and eyes. 

Jeannet-Peter, N., Piletta-Zanin, P. A., Hauser, C. (1999). Facial dermatitis, contact urticaria, rhinoconjunctivitis, and asthma induced by potato. Am. J. Contact Dermat, 10,40 2. 

Cromolyn and nedocromil solutions are also useful in reducing symptoms of allergic rhinoconjunctivitis. Applying the solution by nasal spray or eye drops several times a day is effective in about 75% of patients, even during the peak pollen season. 

A 23-year-old man, with a history of asthma, house dust mite allergy, and rhinoconjunctivitis, presented with acute respiratory symptoms. He was given oral cetirizine, inhaled salmeterol, and fluticasone propionate, and oral prednisone 40 mg/day for 1 week and 20 mg/day for 1 week. His asthma recurred when prednisone was withdrawn and he took oral prednisone 60 mg/day for 1 week and 40 mg/day for 1 week. He also took montelukast 10 mg/day. He then developed severe peripheral edema with a gain in weight of 13 kg. Prednisone was withdrawn and his edema resolved. Montelukast was continued. 

Vourdas D, Syrigou E, Potamianou P, Carat F, Batard T, Andre C, Papageorgiou PS Double-blind, placebo-controlled evaluation of sublingual immunotherapy with standardized olive pollen extract in pediatric patients with allergic rhinoconjunctivitis and mild asthma due to olive pollen sensitization. Allergy 1998 53 662-672. 

Passalacqua G, Albano M, Fregonese L, Riccio A, Pronzato C, Mela GS, Canonica GW Randomised controlled trial of local allergoid immunotherapy on allergic inflammation in mite-induced rhinoconjunctivitis. Lancet 1998 29 968-973. 

Purrello-D Ambrosio F, Gangemi S, Isola S, La Motta N, Puccinelli P, Parmiani S, Savi E, Ricciardi L Sublingual immunotherapy A double-blind, placebo-controlled trial with Parietaria judaica extract standardized in mass units in patients with rhinoconjunctivitis, asthma, or both. Allergy 1999 29 968-973. 

La Rosa M, Ranno C, Andri C, Carat F, Tosca MA, Canonica GW Double-blind placebo-controlled evaluation of sublingual-swallow immunotherapy with standardized Parietaria judaica extract in children with allergic rhinoconjunctivitis. J Allergy Clin Immunol 1999 104 ... 

Khinchi MS, Poulsen LK, Carat F, Andre C, Mailing HJ Clinical efficacy of sublingual-swallow and subcutaneous immunotherapy in patients with allergic rhinoconjunctivitis due to birch pollen. A double-blind, double-dummy placebo-controlled study. Allergy 2000 54(suppl 63) 24. 

Wessner DB, Wessner S, Mohrenschlager M, Rakoski J, Ring J Efficacy and safety of sublingual immunotherapy in adults with allergic rhinoconjunctivitis Results after 2 years of a controlled trial (abstract). Allergy 2001 56(suppl 68) 88. 

Moller C, Dreborg S, Ferdousi HA, et al Pollen immunotherapy reduces the development of asthma in children with seasonal rhinoconjunctivitis (the PAT-study). J Allergy Clin Immunol... 

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