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Clinical Manifestations of Allergic Rhinitis

Nina Lakhani, Michelle North and Anne K. Ellis*

Objective: To provide a concise review of the classification, nasal manifestations, non-nasal manifestations, and quality of life impact of allergic rhinitis.

Data sources: MEDLINE (PubMed) search using the terms allergic rhinitis, combined with the terms perennial, seasonal, non-nasal, symptoms and quality of life.

Study selection: Human studies and reviews published in the English language.

Results: The prevalence of allergic rhinitis is increasing worldwide. Symptoms include rhinorrhea, sneezing, obstruction of the nasal passages, and may be underestimated by patients. Traditionally, allergic rhinitis has been classified as perennial or seasonal; however, the Allergic Rhinitis and its Impact on Asthma (ARIA) classification may provide a better description of individual symptoms. Complications of allergic rhinitis include nasal polyps and bacterial sinusitis and comorbid conditions include asthma, allergic conjunctivitis and atopic dermatitis. The list of potential differential diagnoses is extensive, but important not to miss are the rare presentations of nasopharyngeal tumors, Wegener’s Granulomatosis and sarcoidosis. Epidemiological studies have shown a reduction in quality of life in patients suffering from allergic rhinitis and new tools have allowed for better assessments of the impact of illness on patient’s lives.

Conclusion: Patients with allergic rhinitis can experience a wide range of troublesome clinical symptoms, which are often under recognized and underreported causing a delay in seeking medical attention and subsequent reduction in health related quality of life.