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{{Rhinitis}}
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==Overview==
==Overview==
One of the most common diseases presenting to physicians is chronic rhinitis, and determination of the etiology is crucial to ensure appropriate management.<ref name="pmid17153005">{{cite journal| author=Settipane RA, Charnock DR| title=Epidemiology of rhinitis: allergic and nonallergic. | journal=Clin Allergy Immunol | year= 2007 | volume= 19 | issue=  | pages= 23-34 | pmid=17153005 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17153005  }} </ref> Allergic rhinitis is the most common type of chronic rhinitis,<ref name="pmid24007929">{{cite journal| author=Sacre-Hazouri JA| title=[Chronic rhinosinusitis in children]. | journal=Rev Alerg Mex | year= 2012 | volume= 59 | issue= 1 | pages= 16-24 | pmid=24007929 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24007929  }} </ref><ref name="pmid25645524">{{cite journal| author=Seidman MD, Gurgel RK, Lin SY, Schwartz SR, Baroody FM, Bonner JR et al.| title=Clinical practice guideline: allergic rhinitis executive summary. | journal=Otolaryngol Head Neck Surg | year= 2015 | volume= 152 | issue= 2 | pages= 197-206 | pmid=25645524 | doi=10.1177/0194599814562166 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25645524  }} </ref> and it has been estimated as the fifth most common chronic ailment overall in the U.S.<ref name="pmid25645524">{{cite journal| author=Seidman MD, Gurgel RK, Lin SY, Schwartz SR, Baroody FM, Bonner JR et al.| title=Clinical practice guideline: allergic rhinitis executive summary. | journal=Otolaryngol Head Neck Surg | year= 2015 | volume= 152 | issue= 2 | pages= 197-206 | pmid=25645524 | doi=10.1177/0194599814562166 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25645524  }} </ref> Allergic rhinitis is triggered by the inhalation of indoor and outdoor aeroallergens such as pollens, molds, and animal dander.<ref name="pmid18331513">{{cite journal| author=Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A et al.| title=Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). | journal=Allergy | year= 2008 | volume= 63 Suppl 86 | issue=  | pages= 8-160 | pmid=18331513 | doi=10.1111/j.1398-9995.2007.01620.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18331513  }} </ref><ref name="pmid20176255">{{cite journal| author=Dykewicz MS, Hamilos DL| title=Rhinitis and sinusitis. | journal=J Allergy Clin Immunol | year= 2010 | volume= 125 | issue= 2 Suppl 2 | pages= S103-15 | pmid=20176255 | doi=10.1016/j.jaci.2009.12.989 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20176255  }} </ref> Nonallergic rhinitis comprises a heterogenous group of disorders, some of which are still poorly defined and understood.<ref name="pmid21364228">{{cite journal| author=Sin B, Togias A| title=Pathophysiology of allergic and nonallergic rhinitis. | journal=Proc Am Thorac Soc | year= 2011 | volume= 8 | issue= 1 | pages= 106-14 | pmid=21364228 | doi=10.1513/pats.201008-057RN | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21364228  }} </ref> Nonallergic rhinitis can be induced by non-specific triggers such as exposure to chemical odors, cigarette smoke, spicy food, exercise, and cold air.<ref name="CTOIA">{{cite journal |last=Paraskevopoulos |first=Giannis |last2=Kalogiros |first2=Lampros |date=March 2016 |title=Non-Allergic Rhinitis |url=http://link.springer.com/article/10.1007/s40521-016-0072-6 |journal=Current Treatment Options in Allergy |volume= Volume 3 |issue= Issue 1 |pages=45–68 |doi=10.1007/s40521-016-0072-6 |access-date=January 5, 2017 }}</ref>
==Causes==
===Common Causes===
*Allergic rhinitis- This is the most common cause of chronic rhinitis.<ref name="pmid 20176255">{{cite journal| author=Dykewicz MS, Hamilos DL| title=Rhinitis and sinusitis. | journal=J Allergy Clin Immunol | year= 2010 | volume= 125 | issue= 2 Suppl 2 | pages= S103-15 | pmid= 20176255 | doi=10.1016/j.jaci.2009.12.989 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20176255  }} </ref> The common triggers are listed in the table below.
*Infectious rhinitis- This is the most common cause of nonallergic rhinitis in children.<ref name="pmid11449200">{{cite journal| author=Skoner DP| title=Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. | journal=J Allergy Clin Immunol | year= 2001 | volume= 108 | issue= 1 Suppl | pages= S2-8 | pmid=11449200 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11449200  }} </ref> 98% of acute infectious rhinitis are due to viral upper respiratory infections.<ref name="pmid18662584">{{cite journal| author=Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al.| title=The diagnosis and management of rhinitis: an updated practice parameter. | journal=J Allergy Clin Immunol | year= 2008 | volume= 122 | issue= 2 Suppl | pages= S1-84 | pmid=18662584 | doi=10.1016/j.jaci.2008.06.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18662584  }} </ref>  It is commonly associated with sinusitis ([[rhinosinusitis]]).<ref name="Diseases of the Sinuses">{{cite book |last1=Romeo |first1=Jonathan |last2=Dykewicz |first2=Mark |title=Diseases of the Sinuses |publisher=Springer New York |date=2014 |pages=133-152 |chapter=Chapter 9:Differential Diagnosis of Rhinitis and Rhinosinusitis |isbn=978-1-4939-0265-1}}</ref> Symptoms usually resolve within 7-10 days of onset.<ref name="Diseases of the Sinuses">{{cite book |last1=Romeo |first1=Jonathan |last2=Dykewicz |first2=Mark |title=Diseases of the Sinuses |publisher=Springer New York |date=2014 |pages=133-152 |chapter=Chapter 9:Differential Diagnosis of Rhinitis and Rhinosinusitis |isbn=978-1-4939-0265-1}}</ref> Common viruses implicated are [[Rhinovirus|rhinoviruses]], [[Influenza virus|influenza viruses]] and [[parainfluenza viruses]].<ref name="pmid21364226">{{cite journal| author=Brook I| title=Microbiology of sinusitis. | journal=Proc Am Thorac Soc | year= 2011 | volume= 8 | issue= 1 | pages= 90-100 | pmid=21364226 | doi=10.1513/pats.201006-038RN | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21364226  }} </ref>
*[[Vasomotor rhinitis]]- This is the most common type of nonallergic rhinitis in the adult population.<ref name="pmid20425499">{{cite journal| author=Pattanaik D, Lieberman P| title=Vasomotor rhinitis. | journal=Curr Allergy Asthma Rep | year= 2010 | volume= 10 | issue= 2 | pages= 84-91 | pmid=20425499 | doi=10.1007/s11882-010-0089-z | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20425499  }} </ref><ref name="pmid21364228">{{cite journal| author=Sin B, Togias A| title=Pathophysiology of allergic and nonallergic rhinitis. | journal=Proc Am Thorac Soc | year= 2011 | volume= 8 | issue= 1 | pages= 106-14 | pmid=21364228 | doi=10.1513/pats.201008-057RN | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21364228  }} </ref> The causes of vasomotor rhinitis are listed below.
{| class="wikitable"
!Class
!Causes of Rhinitis<ref name="pmid18662584">{{cite journal| author=Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al.| title=The diagnosis and management of rhinitis: an updated practice parameter. | journal=J Allergy Clin Immunol | year= 2008 | volume= 122 | issue= 2 Suppl | pages= S1-84 | pmid=18662584 | doi=10.1016/j.jaci.2008.06.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18662584  }} </ref><ref name="pmid21737036">{{cite journal| author=Kaliner MA| title=Nonallergic rhinopathy (formerly known as vasomotor rhinitis). | journal=Immunol Allergy Clin North Am | year= 2011 | volume= 31 | issue= 3 | pages= 441-55 | pmid=21737036 | doi=10.1016/j.iac.2011.05.007 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21737036  }} </ref><ref name="Diseases of the Sinuses">{{cite book |last1=Romeo |first1=Jonathan |last2=Dykewicz |first2=Mark |title=Diseases of the Sinuses |publisher=Springer New York |date=2014 |pages=133-152 |chapter=Chapter 9:Differential Diagnosis of Rhinitis and Rhinosinusitis |isbn=978-1-4939-0265-1}}</ref><ref name="pmid18331513">{{cite journal| author=Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A et al.| title=Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). | journal=Allergy | year= 2008 | volume= 63 Suppl 86 | issue=  | pages= 8-160 | pmid=18331513 | doi=10.1111/j.1398-9995.2007.01620.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18331513  }} </ref>
|-
!
!
|-
|Allergic rhinitis
|Indoor and outdoor substances such as:
* Pollens (such as weed pollen like Salsola in the Middle East, cereal pollen in Turkey, cedar, birch and cypress pollen in Japan, etc)<ref name="pmid22092947">{{cite journal| author=Katelaris CH, Lee BW, Potter PC, Maspero JF, Cingi C, Lopatin A et al.| title=Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America. | journal=Clin Exp Allergy | year= 2012 | volume= 42 | issue= 2 | pages= 186-207 | pmid=22092947 | doi=10.1111/j.1365-2222.2011.03891.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22092947  }} </ref> 
* Molds and yeasts
* Mites(house dust mite fetal particles, other mites)
* Insects (coakroach residues, crickets, etc)
* Animal danders, urine and saliva (cats, dogs, horses, rodents, etc)
* Silkworm<ref name="pmid22092947">{{cite journal| author=Katelaris CH, Lee BW, Potter PC, Maspero JF, Cingi C, Lopatin A et al.| title=Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America. | journal=Clin Exp Allergy | year= 2012 | volume= 42 | issue= 2 | pages= 186-207 | pmid=22092947 | doi=10.1111/j.1365-2222.2011.03891.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22092947  }} </ref>
* Silk<ref name="pmid22092947">{{cite journal| author=Katelaris CH, Lee BW, Potter PC, Maspero JF, Cingi C, Lopatin A et al.| title=Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America. | journal=Clin Exp Allergy | year= 2012 | volume= 42 | issue= 2 | pages= 186-207 | pmid=22092947 | doi=10.1111/j.1365-2222.2011.03891.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22092947  }} </ref>
* Latex<ref name="pmid22092947">{{cite journal| author=Katelaris CH, Lee BW, Potter PC, Maspero JF, Cingi C, Lopatin A et al.| title=Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America. | journal=Clin Exp Allergy | year= 2012 | volume= 42 | issue= 2 | pages= 186-207 | pmid=22092947 | doi=10.1111/j.1365-2222.2011.03891.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22092947  }} </ref>
* Some ornamental plants
|-
| rowspan="3" |Nonallergic rhinitis
|[[Vasomotor rhinitis]]
* Irritant triggered- Strong odors from chemicals like chlorine, cooking smells, flowers,  perfumes, environmental tobacco smoke and pollutants
* Cold air/Dry air
* Exercise
* Emotional
* Trauma<ref name="pmid10030243">{{cite journal| author=Segal S, Shlamkovitch N, Eviatar E, Berenholz L, Sarfaty S, Kessler A| title=Vasomotor rhinitis following trauma to the nose. | journal=Ann Otol Rhinol Laryngol | year= 1999 | volume= 108 | issue= 2 | pages= 208-10 | pmid=10030243 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10030243  }} </ref>
* Sexual activity<ref name="pmid11284809">{{cite journal| author=Monteseirin J, Camacho MJ, Bonilla I, Sánchez-Hernández C, Hernández M, Conde J| title=Honeymoon rhinitis. | journal=Allergy | year= 2001 | volume= 56 | issue= 4 | pages= 353-4 | pmid=11284809 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11284809  }} </ref>
* Undetermined or poorly defined triggers
|-
|Gustatory rhinitis- Triggered by solid/liquid food ingestion such as
* Hot food
* Spicy food
* [[Alcohol]]
|-
|Infectious
* [[Viruses]]
* [[Bacteria]]
* [[Fungi]]
* [[Parasites]]
|-
|Occupational rhinitis
|Caused by protein and chemical allergens, chemical respiratory sensitizers, or unknown mechanisms
*Noxious fumes/vapors/smoke/dust- Pesticides, chromium vapors, volatile organic compounds, tthermal degradation products of polyurethanes, grain and cotton dust, chlorine, formaldehyde, ammonia, wood dust, waste handling, solder fumes, detergent powder, flour, lab animal danders, etc
|-
| rowspan="4" |Other rhinitis syndrome
|Hormonally induced
* [[Gestation]]al/[[Pregnancy]]-induced
* [[Menstrual cycle]] related
|-
|Drug-induced<ref name="pmid20210811">{{cite journal| author=Varghese M, Glaum MC, Lockey RF| title=Drug-induced rhinitis. | journal=Clin Exp Allergy | year= 2010 | volume= 40 | issue= 3 | pages= 381-4 | pmid=20210811 | doi=10.1111/j.1365-2222.2009.03450.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20210811  }} </ref>
* [[Rhinitis medicamentosa]]
# Nasal decongestant sprays- Sympathomimetics([[Amphetamine]], [[Benzedrine]], [[Ephedrine]], [[Phenylephrine]], [[Phenylpropanolamine]]), Imidazolines([[Naphazoline]], [[Oxymetazoline]], [[Xylometazoline]])
# Intranasal cocaine and [[methamphetamine]]
* [[Oral contraceptives]] and Exogenous estrogens
* [[Antihypertensives]] and cardiovascular agents- [[ACE inhibitor|ACE inhibitors]], [[Beta blockers]](oral and intraocular), [[Calcium channel blockers]], [[Thiazide diuretics]], centrally acting sympatholytics([[clonidine]], [[guanfacine]], [[methyldopa]], [[moxonidine]], [[reserpine]]), peripherally acting sympatholytics([[prazosin]], [[guanethidine]], [[indoramin]], [[doxazosin]], [[phentolamine]]), [[Hydralazine]].
* [[Aspirin]]/[[NSAIDs]]
* Other medications such as phosphodiesterase-5 selective inhibitors([[sildenafil]], [[tadalafil]], [[Vardenafil|vardenafi]]<nowiki/>l), [[Gabapentin]], some psychotropic medications(chlordiazepoxide-amitryptiline, [[chlorpromazine]], [[risperidone]], [[thioridazine]])
|-
|[[Atrophic rhinitis|Primary atrophic rhinitis]]- causes include:
* Infection with organisms such as Klebsiella ozaenae
* Turbulent air flow
* Climate factors
* Racial factors
[[Atrophic rhinitis|Secondary atrophic rhinitis]]- causes include:
* Extensive surgery
* [[Granulomatous]] diseases
* Direct trauma
* [[Radiotherapy]]
|-
|Rhinitis associated with inflammatory-immunologic disorders
* Granulomatous infections
* [[Wegener's granulomatosis|Wegener granulomatosis]]
* [[Sarcoidosis]]
* [[Sjögren's syndrome|Sjogren's syndrome]]
* Midline granuloma
* [[Churg-Strauss syndrome]]
* [[Relapsing polychondritis]]
* [[Amyloidosis]]
|}
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
| style="width:25%" bgcolor="lightsteelblue" ; border="1" |'''Cardiovascular'''
| style="width:75%" bgcolor="beige" ; border="1" | No underlying causes
|-
| bgcolor="lightsteelblue" | '''Chemical/Poisoning'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Dental'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Dermatologic'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Drug Side Effect'''
| bgcolor="beige" |  [[Aspirin]], [[NSAIDs|NSAID]], [[Clonidine]], [[Guanfacine]], [[Methyldopa]], [[Moxonidine]], [[Rescinnamine]], [[Reserpine]], [[Rilmenidine]], [[Mecamylamine]], [[Trimethaphan]],[[Prazosin]], [[Guanethidine]], [[Indoramin]], [[Doxazosin]], [[Phentolamine]], [[Sildenafil]], [[Tadalafil]], [[Vardenafil]], [[Amiloride]], [[ACE inhibitor|ACE inhibitors]], oral [[Beta blockers]], intraocular beta blockers, [[calcium channel blockers]], [[Chlorothiazide]], [[Hydralazine]], [[Hydrochlorothiazide]], Exogenous estrogens, [[oral contraceptives]], Chlordiazepoxide-Amitryptiline, [[Chlorpromazine]], [[Risperidone]], [[Thioridazine]], [[Gabapentin]],[[Butorphanol]], [[Cefpodoxime]], [[Desmopressin]], [[Dimercaprol]], [[Dornase Alfa]], [[Flunisolide]], [[Flurbiprofen]], [[Ivacaftor]], [[Moxifloxacin ophthalmic]], [[Nilutamide]], [[Rifaximin]], [[Rimexolone]], [[Sertraline]], [[Tamsulosin]], [[Trichophyton mentagrophytes and Trichophyton rubrum]], [[Thalidomide]], [[Tizanidine]], [[Topiramate]]
|-
|- bgcolor="lightsteelblue"
| '''Ear Nose Throat'''
| bgcolor="beige" | [[Upper respiratory tract infections]]- Viral, Bacterial, Fungal and Parasitic
|-
|- bgcolor="lightsteelblue"
| '''Endocrine'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Environmental'''
| bgcolor="beige" |Pollens, molds, animal dander, coakroach residues, dust mite fecal particles
|-
|- bgcolor="lightsteelblue"
| '''Gastroenterologic'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Genetic'''
| bgcolor="beige" | Genetic predisposition(Allergic rhinitis)
|-
|- bgcolor="lightsteelblue"
| '''Hematologic'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Iatrogenic'''
| bgcolor="beige" | Secondary atrophic rhinitis (Surgical removal of nasal turbinates, Radiation)
|-
|- bgcolor="lightsteelblue"
| '''Infectious Disease'''
| bgcolor="beige" | [[Rhinovirus]], [[Adenovirus]], [[Influenza]] and [[Parainfluenza viruses]], Klebsiella ozaenae, [[Klebsiella rhinoscleromatis]], [[Syphilis]]
|-
|- bgcolor="lightsteelblue"
| '''Musculoskeletal/Orthopedic'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Neurologic'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Nutritional/Metabolic'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Obstetric/Gynecologic'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Oncologic'''
| bgcolor="beige" | Midline granuloma
|-
|- bgcolor="lightsteelblue"
| '''Ophthalmologic'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Overdose/Toxicity'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Psychiatric'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Pulmonary'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Renal/Electrolyte'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Rheumatology/Immunology/Allergy'''
| bgcolor="beige" | Pollens, Animal danders, Molds, Protein and chemical allergens
|-
|- bgcolor="lightsteelblue"
| '''Sexual'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Trauma'''
| bgcolor="beige" | Nose trauma
|-
|- bgcolor="lightsteelblue"
| '''Urologic'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Miscellaneous'''
| bgcolor="beige" | No underlying causes
|-
|}
==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{WH}}
{{WH}}
{{WS}}
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Otolaryngology]]
[[Category:Immunology]]

Latest revision as of 00:00, 30 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]

Overview

One of the most common diseases presenting to physicians is chronic rhinitis, and determination of the etiology is crucial to ensure appropriate management.[1] Allergic rhinitis is the most common type of chronic rhinitis,[2][3] and it has been estimated as the fifth most common chronic ailment overall in the U.S.[3] Allergic rhinitis is triggered by the inhalation of indoor and outdoor aeroallergens such as pollens, molds, and animal dander.[4][5] Nonallergic rhinitis comprises a heterogenous group of disorders, some of which are still poorly defined and understood.[6] Nonallergic rhinitis can be induced by non-specific triggers such as exposure to chemical odors, cigarette smoke, spicy food, exercise, and cold air.[7]

Causes

Common Causes

  • Allergic rhinitis- This is the most common cause of chronic rhinitis.[8] The common triggers are listed in the table below.
  • Infectious rhinitis- This is the most common cause of nonallergic rhinitis in children.[9] 98% of acute infectious rhinitis are due to viral upper respiratory infections.[10] It is commonly associated with sinusitis (rhinosinusitis).[11] Symptoms usually resolve within 7-10 days of onset.[11] Common viruses implicated are rhinoviruses, influenza viruses and parainfluenza viruses.[12]
  • Vasomotor rhinitis- This is the most common type of nonallergic rhinitis in the adult population.[13][6] The causes of vasomotor rhinitis are listed below.
Class Causes of Rhinitis[10][14][11][4]
Allergic rhinitis Indoor and outdoor substances such as:
  • Pollens (such as weed pollen like Salsola in the Middle East, cereal pollen in Turkey, cedar, birch and cypress pollen in Japan, etc)[15]
  • Molds and yeasts
  • Mites(house dust mite fetal particles, other mites)
  • Insects (coakroach residues, crickets, etc)
  • Animal danders, urine and saliva (cats, dogs, horses, rodents, etc)
  • Silkworm[15]
  • Silk[15]
  • Latex[15]
  • Some ornamental plants
Nonallergic rhinitis Vasomotor rhinitis
  • Irritant triggered- Strong odors from chemicals like chlorine, cooking smells, flowers, perfumes, environmental tobacco smoke and pollutants
  • Cold air/Dry air
  • Exercise
  • Emotional
  • Trauma[16]
  • Sexual activity[17]
  • Undetermined or poorly defined triggers
Gustatory rhinitis- Triggered by solid/liquid food ingestion such as
Infectious
Occupational rhinitis Caused by protein and chemical allergens, chemical respiratory sensitizers, or unknown mechanisms
  • Noxious fumes/vapors/smoke/dust- Pesticides, chromium vapors, volatile organic compounds, tthermal degradation products of polyurethanes, grain and cotton dust, chlorine, formaldehyde, ammonia, wood dust, waste handling, solder fumes, detergent powder, flour, lab animal danders, etc
Other rhinitis syndrome Hormonally induced
Drug-induced[18]
  1. Nasal decongestant sprays- Sympathomimetics(Amphetamine, Benzedrine, Ephedrine, Phenylephrine, Phenylpropanolamine), Imidazolines(Naphazoline, Oxymetazoline, Xylometazoline)
  2. Intranasal cocaine and methamphetamine
Primary atrophic rhinitis- causes include:
  • Infection with organisms such as Klebsiella ozaenae
  • Turbulent air flow
  • Climate factors
  • Racial factors

Secondary atrophic rhinitis- causes include:

Rhinitis associated with inflammatory-immunologic disorders

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Aspirin, NSAID, Clonidine, Guanfacine, Methyldopa, Moxonidine, Rescinnamine, Reserpine, Rilmenidine, Mecamylamine, Trimethaphan,Prazosin, Guanethidine, Indoramin, Doxazosin, Phentolamine, Sildenafil, Tadalafil, Vardenafil, Amiloride, ACE inhibitors, oral Beta blockers, intraocular beta blockers, calcium channel blockers, Chlorothiazide, Hydralazine, Hydrochlorothiazide, Exogenous estrogens, oral contraceptives, Chlordiazepoxide-Amitryptiline, Chlorpromazine, Risperidone, Thioridazine, Gabapentin,Butorphanol, Cefpodoxime, Desmopressin, Dimercaprol, Dornase Alfa, Flunisolide, Flurbiprofen, Ivacaftor, Moxifloxacin ophthalmic, Nilutamide, Rifaximin, Rimexolone, Sertraline, Tamsulosin, Trichophyton mentagrophytes and Trichophyton rubrum, Thalidomide, Tizanidine, Topiramate
Ear Nose Throat Upper respiratory tract infections- Viral, Bacterial, Fungal and Parasitic
Endocrine No underlying causes
Environmental Pollens, molds, animal dander, coakroach residues, dust mite fecal particles
Gastroenterologic No underlying causes
Genetic Genetic predisposition(Allergic rhinitis)
Hematologic No underlying causes
Iatrogenic Secondary atrophic rhinitis (Surgical removal of nasal turbinates, Radiation)
Infectious Disease Rhinovirus, Adenovirus, Influenza and Parainfluenza viruses, Klebsiella ozaenae, Klebsiella rhinoscleromatis, Syphilis
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Midline granuloma
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy Pollens, Animal danders, Molds, Protein and chemical allergens
Sexual No underlying causes
Trauma Nose trauma
Urologic No underlying causes
Miscellaneous No underlying causes

References

  1. ↑ Settipane RA, Charnock DR (2007). "Epidemiology of rhinitis: allergic and nonallergic". Clin Allergy Immunol. 19: 23–34. PMID 17153005.
  2. ↑ Sacre-Hazouri JA (2012). "[Chronic rhinosinusitis in children]". Rev Alerg Mex. 59 (1): 16–24. PMID 24007929.
  3. ↑ 3.0 3.1 Seidman MD, Gurgel RK, Lin SY, Schwartz SR, Baroody FM, Bonner JR; et al. (2015). "Clinical practice guideline: allergic rhinitis executive summary". Otolaryngol Head Neck Surg. 152 (2): 197–206. doi:10.1177/0194599814562166. PMID 25645524.
  4. ↑ 4.0 4.1 Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A; et al. (2008). "Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen)". Allergy. 63 Suppl 86: 8–160. doi:10.1111/j.1398-9995.2007.01620.x. PMID 18331513.
  5. ↑ Dykewicz MS, Hamilos DL (2010). "Rhinitis and sinusitis". J Allergy Clin Immunol. 125 (2 Suppl 2): S103–15. doi:10.1016/j.jaci.2009.12.989. PMID 20176255.
  6. ↑ 6.0 6.1 Sin B, Togias A (2011). "Pathophysiology of allergic and nonallergic rhinitis". Proc Am Thorac Soc. 8 (1): 106–14. doi:10.1513/pats.201008-057RN. PMID 21364228.
  7. ↑ Paraskevopoulos, Giannis; Kalogiros, Lampros (March 2016). "Non-Allergic Rhinitis". Current Treatment Options in Allergy. Volume 3 (Issue 1): 45–68. doi:10.1007/s40521-016-0072-6. Retrieved January 5, 2017.
  8. ↑ Dykewicz MS, Hamilos DL (2010). "Rhinitis and sinusitis". J Allergy Clin Immunol. 125 (2 Suppl 2): S103–15. doi:10.1016/j.jaci.2009.12.989. PMID 20176255  20176255 Check |pmid= value (help).
  9. ↑ Skoner DP (2001). "Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis". J Allergy Clin Immunol. 108 (1 Suppl): S2–8. PMID 11449200.
  10. ↑ 10.0 10.1 Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA; et al. (2008). "The diagnosis and management of rhinitis: an updated practice parameter". J Allergy Clin Immunol. 122 (2 Suppl): S1–84. doi:10.1016/j.jaci.2008.06.003. PMID 18662584.
  11. ↑ 11.0 11.1 11.2 Romeo, Jonathan; Dykewicz, Mark (2014). "Chapter 9:Differential Diagnosis of Rhinitis and Rhinosinusitis". Diseases of the Sinuses. Springer New York. pp. 133–152. ISBN 978-1-4939-0265-1.
  12. ↑ Brook I (2011). "Microbiology of sinusitis". Proc Am Thorac Soc. 8 (1): 90–100. doi:10.1513/pats.201006-038RN. PMID 21364226.
  13. ↑ Pattanaik D, Lieberman P (2010). "Vasomotor rhinitis". Curr Allergy Asthma Rep. 10 (2): 84–91. doi:10.1007/s11882-010-0089-z. PMID 20425499.
  14. ↑ Kaliner MA (2011). "Nonallergic rhinopathy (formerly known as vasomotor rhinitis)". Immunol Allergy Clin North Am. 31 (3): 441–55. doi:10.1016/j.iac.2011.05.007. PMID 21737036.
  15. ↑ 15.0 15.1 15.2 15.3 Katelaris CH, Lee BW, Potter PC, Maspero JF, Cingi C, Lopatin A; et al. (2012). "Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America". Clin Exp Allergy. 42 (2): 186–207. doi:10.1111/j.1365-2222.2011.03891.x. PMID 22092947.
  16. ↑ Segal S, Shlamkovitch N, Eviatar E, Berenholz L, Sarfaty S, Kessler A (1999). "Vasomotor rhinitis following trauma to the nose". Ann Otol Rhinol Laryngol. 108 (2): 208–10. PMID 10030243.
  17. ↑ Monteseirin J, Camacho MJ, Bonilla I, Sánchez-Hernández C, Hernández M, Conde J (2001). "Honeymoon rhinitis". Allergy. 56 (4): 353–4. PMID 11284809.
  18. ↑ Varghese M, Glaum MC, Lockey RF (2010). "Drug-induced rhinitis". Clin Exp Allergy. 40 (3): 381–4. doi:10.1111/j.1365-2222.2009.03450.x. PMID 20210811.

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