DESCRIPTION

IgE antibody–mediated inflammation of the nasal and sinus mucosa, associated with sneezing, swelling, increased mucus production, and nasal obstruction; may be classified as seasonal, perennial, or a combination

• Seasonal: periodic symptoms, involving the same season for at least 2 consecutive years; most often due to pollens (e.g., trees, grass, weeds) and outdoor spores
• Perennial: occurring at least 9 months of the year
  • May be more difficult to detect because of overlap with viral infections
  • May be due to multiple seasonal allergies or continual exposure to allergens (e.g., dust mites, cockroaches, molds and animal dander)
• Perennial with seasonal exacerbations
• Can also classify by frequency: intermittent (<4 days/week or <4 weeks/year), persistent (>4 days/week or >4 weeks/year), or by severity of symptoms

EPIDEMIOLOGY

• Most common allergic disease, affecting approximately 40 million Americans; affects 40% of children and 15–30% of adolescents
• Prevalence is increasing, especially in westernized countries.

ETIOLOGY

Pollens (grasses, trees, weeds), molds, dust mite, cockroach, animal dander

RISK FACTORS

Increased incidence in families with atopic disease; also increased risk with exposure to particulate air pollution, and maternal tobacco use

COMMONLY ASSOCIATED CONDITIONS

• Asthma
• Allergic conjunctivitis
• Atopic dermatitis (eczema)
• Pollen food allergy syndrome (PFAS)
• Urticaria
• Otitis media with effusion
• Sleep, taste, and/or smell disturbance
• Nasal polyps
• Mouth breathing
• Snoring and sleep-disordered breathing
• Adenoidal hypertrophy
• Decreased appetite
• Delayed speech