Rhinitis classification
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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
Rhinitis can be classified into allergic and nonallergic rhinitis.[1] Some forms of rhinitis are not easily classified as either allergic or nonallergic,[1] and sometimes, there also appear to be an overlap of both allergic and nonallergic rhinitis(sometimes referred to as 'mixed' rhinitis).[2] The classification and diagnosis of nonallergic rhinitis is challenging due to its diverse etiology, and it is also not well understood compared to the allergic type.[3] Nonallergic rhinitis can be induced by non-specific triggers such as exposure to chemical odors, cigarette smoke, spicy food, exercise, cold air, etc.[3]
Classification
- Rhinitis can be broadly classified into allergic and nonallergic rhinitis, however, some forms of rhinitis cannot be easily classified into these two categories.[1] A comprehensive classification of rhinitis based on the etiology is depicted below:
| Classification of Rhinitis[1][4] | ||
|---|---|---|
| Class | Types/causes | |
| Allergic rhinitis | US Joint Task Force on Practice Parameters(JTF) classification of allergic rhinitis | Seasonal (hay fever) |
| Perennial | ||
| Episodic | ||
| Allergic Rhinitis and its Impact on Asthma(ARIA) classification of allergic rhinitis | Intermittent | |
| Persistent | ||
| Nonallergic rhinitis | Vasomotor rhinitis | Irritant triggered |
| Cold air/Dry air | ||
| Exercise | ||
| Emotional | ||
| Undetermined or poorly defined triggers | ||
| Gustatory rhinitis | ||
| Infectious | Acute | |
| Chronic | ||
| NARES
(Nonallergic rhinitis with eosinophilia syndrome) |
||
| Occupational rhinitis | IgE-mediated
(caused by protein and chemical allergens) |
|
| Immune mechanism uncertain
(caused by chemical respiratory sensitizers) |
||
| Work-aggravated rhinitis | ||
| Other rhinitis syndromes | Hormonally induced | Gestational |
| Menstrual cycle related | ||
| Drug-induced | Rhinitis medicamentosa | |
| Oral contraceptives | ||
| Antihypertensives and cardiovascular agents | ||
| Aspirin/NSAIDs | ||
| Other drugs | ||
| Atrophic rhinitis | ||
| Rhinitis associated with inflammatory-immunologic disorders | Granulomatous infections | |
| Wegener granulomatosis | ||
| Sarcoidosis | ||
| Midline granuloma | ||
| Churg-Strauss | ||
| Relapsing polychondritis | ||
| Amyloidosis | ||
- Allergic rhinitis can also be graded by the level of severity. However, there is no generally accepted method for grading the severity of allergic rhinitis.[1]
| Modified Classification of Allergic Rhinitis According to Severity of Symptoms and Quality of Life Impairment[5][6][7]
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|---|---|
| Type of allergic rhinitis | Clinical characteristic |
| Intermittent | Symptoms are present on fewer than four days a week and for less than four weeks |
| Persistent | Symptoms are present on more than four days a week and for more than four consecutive weeks |
| |
References
- ↑ 1.0 1.1 1.2 1.3 1.4 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 PMID:18662584 Check
|pmid=value (help). - ↑ Settipane RA, Charnock DR (2007). "Epidemiology of rhinitis: allergic and nonallergic". Clin Allergy Immunol. 19: 23–34. PMID 17153005.
- ↑ 3.0 3.1 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.
- ↑ Sacre-Hazouri JA (2012). "[Chronic rhinosinusitis in children]". Rev Alerg Mex. 59 (1): 16–24. PMID 24007929 PMID: 24007929 Check
|pmid=value (help). - ↑ Sacre-Hazouri JA (2012). "[Chronic rhinosinusitis in children]". Rev Alerg Mex. 59 (1): 16–24. PMID pmid24007929 Check
|pmid=value (help). - ↑ 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.
- ↑ Van Hoecke H, Vastesaeger N, Dewulf L, De Bacquer D, van Cauwenberge P (2006). "Is the allergic rhinitis and its impact on asthma classification useful in daily primary care practice?". J Allergy Clin Immunol. 118 (3): 758–9. doi:10.1016/j.jaci.2006.05.015. PMID 16950299.