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Published on : Mar 14, 2014
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Slide 1 - Allergic Rhinitis Richard Douglas
Slide 2 - Prevalence Most common disease 20% adult population
Slide 3 - Diagnosis What’s the problem? nasal blockage clear rhinorrhoea sneezing itchy eyes
Slide 4 - Diagnosis When during the year do you get these symptoms? perennial worse in springtime
Slide 5 - Pathogenesis IgE mediated hypersensitivity to common aeroallergens Release of histamines, leukotrienes
Slide 6 - More history Previous medications occasional antihistamine, Otrivine spray Past medical history mild asthma as child Drug allergies nil
Slide 7 - Examination Headlight, Thuddicum’s speculum Nasendoscope Otoscope
Slide 8 - Investigations Skin prick tests
Slide 9 - Atopy Atopy is an inherited predisposition to produce IgE to environmental allergens
Slide 10 - Non-atopics Atopics AllergicRhinitis
Slide 11 - Differential diagnosis Allergic rhinitis Non-allergic rhinitis with eosinophilia Vasomotor rhinitis
Slide 12 - Treatment Drugs Allergen avoidance Immunotherapy Surgery
Slide 13 - Drugs Antihistamines Intermittent symptoms Work quickly Expensive Intranasal steroids Constant symptoms Slow onset of action Inexpensive
Slide 14 - Nasal Obstruction
Slide 15 - Allergen avoidance Grass pollen difficult to avoid Best trial of dust mite avoidance shows no effect on allergic rhinitis
Slide 16 - Immunotherapy Repeated exposure to high doses of allergen causes anergy Low dose to high dose Three year course Risk of anaphylaxis Highly effective when the allergen is known
Slide 17 - ppt slide no 17 content not found
Slide 18 - What is the role of surgery? Highly effective Submucosal resection for good long term results