Allergic rhinitis in Child
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Synopsis

Allergic rhinitis (AR) is a common cause of nasal congestion, rhinorrhea, sneezing, and lacrimation. Patients with AR often present with itching of the nose, throat, and eyes as well as cough, postnasal drip, and fatigue. It affects up to 20% of individuals in the United States. There are many triggers, including plants, animal dander, pollens, and molds. These allergens are thought to cause AR through immunoglobulin E (IgE)-mediated mast cell degranulation in the nasal mucosa.
AR may present with a seasonal, occupational, or perennial (chronic) pattern. More recently, however, AR has been categorized as "intermittent," "persistent," "mild," or "moderate," depending on duration and frequency of symptoms. The condition affects people of all demographics and locations; however, there is thought to be a higher likelihood of AR in individuals with a family history of allergies. Of note, it is more common in people with atopic conditions such as asthma, atopic dermatitis, and food allergies. AR typically develops before age 20 and frequently diminishes in severity as patients age.
Although not life-threatening, AR can dramatically impact quality of life and school / workplace productivity.
Related topics: drug-induced rhinitis, vasomotor rhinitis
AR may present with a seasonal, occupational, or perennial (chronic) pattern. More recently, however, AR has been categorized as "intermittent," "persistent," "mild," or "moderate," depending on duration and frequency of symptoms. The condition affects people of all demographics and locations; however, there is thought to be a higher likelihood of AR in individuals with a family history of allergies. Of note, it is more common in people with atopic conditions such as asthma, atopic dermatitis, and food allergies. AR typically develops before age 20 and frequently diminishes in severity as patients age.
Although not life-threatening, AR can dramatically impact quality of life and school / workplace productivity.
Related topics: drug-induced rhinitis, vasomotor rhinitis
Codes
ICD10CM:
J30.9 – Allergic rhinitis, unspecified
SNOMEDCT:
61582004 – Allergic Rhinitis
J30.9 – Allergic rhinitis, unspecified
SNOMEDCT:
61582004 – Allergic Rhinitis
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Vasomotor rhinitis – when allergic causes are ruled out, this may be caused by changes in weather, medications, foods, or chronic health conditions
- Drug-induced rhinitis – from use of cocaine, oral contraceptives, NSAIDs, chlorpromazine, rebound from decongestant use
- Nasal polyps – can be found on nasal endoscopy
- Nasal tumor (eg, nasopharyngeal cancer)
- Foreign body – can be determined by thorough history and inspection; usually presents with purulent unilateral rhinorrhea
- Deviated septum
- Choanal atresia in infants
- Adenoid hypertrophy in children
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:03/31/2019
Last Updated:12/20/2020
Last Updated:12/20/2020

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