Rhinitis causes

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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 is a heterogenous group which is still poorly defined and understood.^[6]

Causes

Common Causes

Allergic rhinitis- This is the most common cause of chronic rhinitis.^[7] The common triggers are listed in the table below.
Infectious rhinitis- 98% of acute infectious rhinitis are due to viral upper respiratory infections.^[8] Common viruses implicated are rhinoviruses, influenza viruses and parainfluenza viruses.^[9]
Vasomotor rhinitis- This is the most common type of nonallergic rhinitis in the adult population.^[10]^[6] The causes of vasomotor rhinitis are listed below.

Class	Causes of Rhinitis^[8]^[11]^[12]^[4]

Allergic rhinitis	Indoor and outdoor airborne substances such as: Pollens Molds Dust mite fetal particles Coakroach residues Animal danders
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^[13] 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
Other rhinitis syndrome	Hormonally induced Gestational/Pregnancy-induced Menstrual cycle related
	Drug-induced^[14] 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 inhibitors, Beta blockers(oral and intraocular), Calcium channel blockers, Thiazides 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), Gabapentin, some antipsychotic medications(chlordiazepoxide, chlorpromazine, risperidone, thioridazine)
	Primary atrophic rhinitis- causes include: Infection with organisms such as Klebsiella ozaenae Turbulent air flow Climate factors Racial factors Secondary atrophic rhinitis- causes include: Extensive surgery Granulomatous diseases Direct trauma Radiotherapy
	Rhinitis associated with inflammatory-immunologic disorders Granulomatous infections Wegener granulomatosis Sarcoidosis Sjogren's syndrome Midline granuloma Churg-Strauss syndrome Relapsing polychondritis Amyloidosis

Causes by Organ System

Cardiovascular	No underlying causes
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	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	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
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	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

Adenoid infection
Allergy
Butorphanol
Ciliary dyskinesia
Common cold
Desmopressin
Flunisolide
Flurbiprofen
Hay fever
Immunodeficiency diseases
Ivacaftor
Middle ear infections
Nilutamide
Sexual intercourse (a condition known as sexual catarrh)
Sinusitis
Tonsillitis

References

↑ Settipane RA, Charnock DR (2007). "Epidemiology of rhinitis: allergic and nonallergic". Clin Allergy Immunol. 19: 23–34. PMID 17153005.
↑ Sacre-Hazouri JA (2012). "[Chronic rhinosinusitis in children]". Rev Alerg Mex. 59 (1): 16–24. PMID 24007929.
↑ ^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.
↑ ^4.0 ^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.
↑ 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.
↑ ^6.0 ^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.
↑ 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).
↑ ^8.0 ^8.1 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.
↑ Brook I (2011). "Microbiology of sinusitis". Proc Am Thorac Soc. 8 (1): 90–100. doi:10.1513/pats.201006-038RN. PMID 21364226.
↑ Pattanaik D, Lieberman P (2010). "Vasomotor rhinitis". Curr Allergy Asthma Rep. 10 (2): 84–91. doi:10.1007/s11882-010-0089-z. PMID 20425499.
↑ 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.
↑ 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.
↑ 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.
↑ 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.

Template:WH Template:WS

[pmid17153005-1] Settipane RA, Charnock DR (2007). "Epidemiology of rhinitis: allergic and nonallergic". Clin Allergy Immunol. 19: 23–34. PMID 17153005.

[pmid24007929-2] Sacre-Hazouri JA (2012). "[Chronic rhinosinusitis in children]". Rev Alerg Mex. 59 (1): 16–24. PMID 24007929.

[pmid25645524-3] 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.

[pmid18331513-4] 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.

[pmid20176255-5] 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.

[pmid21364228-6] 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.

[pmid 20176255-7] 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).

[pmid18662584-8] 8.0 ^8.1 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.

[pmid21364226-9] Brook I (2011). "Microbiology of sinusitis". Proc Am Thorac Soc. 8 (1): 90–100. doi:10.1513/pats.201006-038RN. PMID 21364226.

[pmid20425499-10] Pattanaik D, Lieberman P (2010). "Vasomotor rhinitis". Curr Allergy Asthma Rep. 10 (2): 84–91. doi:10.1007/s11882-010-0089-z. PMID 20425499.

[pmid21737036-11] 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.

[Diseases_of_the_Sinuses-12] 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.

[pmid10030243-13] 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.

[pmid20210811-14] 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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