广州医学院：《头颈外科学》课程PPT教学课件（讲稿）第八讲 Allergic Rhinitis

Allergic rhinitis Lizi Qiu E.N.T department The second affiliated hospital Guangzhou Medical college

Allergic Rhinitis Lizi Qiu E.N.T department The second affiliated hospital Guangzhou Medical College

Background o Rhinitis is defined as inflammation of the nasal membranes and is characterized by a symptom complex that consists of any combination of the following: sneezing, nasal congestion nasal itching, and rhinorrhea. Allergic rhinitis is the most common cause of rhinitis

Background ⚫ Rhinitis is defined as inflammation of the nasal membranes and is characterized by a symptom complex that consists of any combination of the following: sneezing, nasal congestion, nasal itching, and rhinorrhea. Allergic rhinitis is the most common cause of rhinitis

Background o Total cost $5. 3 billion per year.(in America) o Morbidity 10%-40%(in China) o Classification Perennial allergic rhinitis Seasonal allergic rhinitis(pollinosis)

Background ⚫ Total cost $5.3 billion per year. (in America) ⚫ Morbidity 10%-40% ( in China) ⚫ Classification Perennial allergic rhinitis Seasonal allergic rhinitis (pollinosis)

Pathophysiology o Allergic reaction is an exaggerated or inappropriate immune reaction and causes damage to the host Type I immediate hypersensitivity reaction mediated by IgE antibodies which trigger the mast cells and basophils to release pharmacologically active agents

Pathophysiology ⚫ Allergic reaction is an exaggerated or inappropriate immune reaction and causes damage to the host ⚫ Type I immediate hypersensitivity reaction mediated by IgE antibodies, which trigger the mast cells and basophils to release pharmacologically active agents

Membrane-bound IgE L Histamine, leukotrienes, Acute Allergic Mast c Interleukin-5 Reaction Wheezy Interleukin-4 Urticaria Sneezing, rhinorrhea unctivitis Allergen Eosinophil IgE production Basic proteins, platelet-activating erleukin-4 Dendrite Th2 Chronic Allergic Further wheezing Histamine-releasing Mast cell lipids Sustained blockage of the nose Eczema MHC class Il T-cell receptor molecule Neurotrophins d

CLINICAL o History: Obtaining a detailed history is important in the evaluation of allergic rhinitis Allergy history environmental exposures occupational exposures effects on quality of life Family history Past medical history

CLINICAL ⚫ History: Obtaining a detailed history is important in the evaluation of allergic rhinitis. Allergy history environmental exposures occupational exposures effects on quality of life Family history • Past medical history

CLINICAL o Signs and Symptoms of Allergic Rhinitis Sneezing Itching(nose, eyes, ears, palate Rhinorrhea( watery secretions) Congestion Hyposmia(嗅觉下降)

CLINICAL ⚫ Signs and Symptoms of Allergic Rhinitis Sneezing Itching (nose, eyes, ears, palate) Rhinorrhea（watery secretions) Congestion Hyposmia （嗅觉下降）

CLINICAL ●" Allergic shiners" ●" Nasal crease" (allergic salute) Nasal examination swol len(boggy), pale, blue-gray mucosa

CLINICAL ⚫ "Allergic shiners" ⚫ "Nasal crease" (allergic salute). ⚫ Nasal examination :swol len (boggy), pale, blue-gray mucosa

Lab Studies K o Total serum IgE ● Finding allergen Common allergen: page 58 Perennial: house dust, mite fungus, pollen chemical material Seasonal: pollen( sunflower, corn, glass

Lab Studies ⚫ Total serum IgE ⚫ Finding allergen Common allergen: page 58 Perennial: house dust ,mite ,fungus, pollen chemical material Seasonal: pollen ( sunflower, corn , glass )

Lab studies Finding allergen a. Skin testing: prick test (点刺试验) intracutaneous test (皮内试验) b Nasal allergen challenge test C Serum special igE determination

Lab Studies Finding allergen a. Skin testing: prick test （点刺试验） intracutaneous test （皮内试验） b. Nasal allergen challenge test c. Serum special IgE determination