allergic rhinoconjunctivitis

after exposure to allergen:
-sneezing
-itching of nose and eyes
-clear rhinorrhea or nasal congestion
It is the most common allergic disease and significantly affects quality of live as well as school performance and attendance. It frequently coexist with asthma. Prevalence is at 15% in the postadolescent years.
The pathologic changes in allergic rhinoconjunctivitis are chiefly hyperemia, edema, and increased serous and mucoid secretions caused by mediator release, all of which lead to variable degrees of nasal obstruction, pruritus, and rhinorrhea.
Laboratory:
Eosinophilia often can be demonstrated on smears of nasal secretions or blood.
Skin testing to identify allergen-specific IgE is the most sensitive and specific test for inhalant allergies, alternatively, radioallergosorbent assay test (RAST), immuno CAP, or other in vitro tests can be done for suspected allergens.
Treatment
* identification and avoidance of causative allergens cannot be overstated.
* antihistamines-to control itching, sneezing, and rhinorrhea. Sedating antihistamines: diphenhydramine, chlorpheniramine, hydroxyzine, clemastine.
* decongestan-phenilephrine and oxymetazoline should not be used for more than 4 days. Pseudoephedrine and phenylpropanolamine are often combined with antihistamines or expectorants.
* corticosteroids- mometasone nasal spray has been approved for use in children.
* other pharmacologic agents- montelukast is approved for perennial allergic rhinitis in children 6 months and older. Intranasal ipratropium can be used as adjunctive therapy for rhinorrhea.
* surgical therapy- turbinectomy and functional sinus surgery