Allergic Rhinitis: keys for the clinician

Keywords: Allergic rhinitis, allergen, allergy, IgE, immunoglobin E


Allergic rhinitis (AR) and asthma are the most common inflammatory diseases of the airways. According to the review of the literature, there is a prevalence of AR of 10-40% worldwide. AR is defined as a type I allergic disease caused by immunoglobulin E mediated inflammation. The symptoms include nasal congestion, watery rhinorrhea and sneezing. In most cases it is accompanied by ocular symptoms like ocular redness, tearing and itchy eyes. AR can have an influence on the quality of life in patients, for example: sleep disturbances, fatigue, irritability, depression, also affect the attention, learning and memory deficits. The classification of AR is seasonal AR, perennial AR, other classification is by duration of symptoms, like intermittent, persistent, also a severity classification, based on disturbances in quality life, proposed by the Allergic Rhinitis and Its Impact on Asthma (ARIA). The first steps in the diagnosis are the clinical history and physical examination of the patient. Also, the diagnosis can include laboratory tests like skin prick test and the determination of immunoglobulin E levels in serum. In the first line of the treatment there is the no pharmacologic changes in the patient’s life, emphasizing the avoidance of contact between the patient and the allergen, and the pharmacological treatment are the second-generation antihistamines, inhaled glucocorticoids and immunotherapy, also alternative treatments can be used like acupuncture, ginger extract and probiotic therapy. Allergic rhinitis represents a limitation in the daily activity of those affected, it affects their quality of life, interferes with their ability to sleep, as well as their life at work and school.


Download data is not yet available.


Pols DH, Wartna JB, Moed H, van Alphen EI, Bohnen AM, Bindels PJ. Atopic dermatitis, asthma and allergic rhinitis in general practice and the open population: a systematic review. Scand J Prim Health Care. 2016;34(2):143-150.

Shen Y, Zeng JH, Hong SL, Kang HY. Prevalence of allergic rhinitis comorbidity with asthma and asthma with allergic rhinitis in China: A meta-analysis. Asian Pac J Allergy Immunol. 2019;37(4):220-5.

Brozek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol. 2017;140(40):950-58.

Khan DA. Allergic rhinitis and asthma: epidemiology and common pathophysiology. Allergy Asthma Proc. 2014;35(5):357-61.

Bernstein DI, Schwartz G, Bernstein JA. Allergic Rhinitis: Mechanisms and Treatment. Immunol Allergy Clin North Am. 2016;36(2):261-78.

Tohidinik HR, Mallah N, Takkouche B. History of allergic rhinitis and risk of asthma; a systematic review and meta-analysis. World Allergy Organ J. 2019;12(10):100069.

Wheatley LM, Togias A. Clinical practice. Allergic rhinitis. N Engl J Med. 2015;372(5):456-63.

Dykewicz MS, Wallace DV, Amrol DJ, Baroody FM, Bernstein JA, Craig TJ, et al. Rhinitis 2020: A practice parameter update. J Allergy Clin Immunol. 2020Oct;146(4):721-67.

Okubo K, Kurono Y, Ichimura K, Enomoto T, Okamoto Y, Kawauchi H, et al. Japanese guidelines for allergic rhinitis 2017. Allergol Int. 2017;66(2):205-19.

Wise SK, Lin SY, Toskala E, Orlandi RR, Akdis CA, Alt JA, et al. International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis. Int Forum Allergy Rhinol. 2018;8(2):108-352.

Dhong HJ. Classification of Allergic Rhinitis: What is Most Suitable in Korea? Allergy Asthma Immunol Res. 2013;5(2):65-7.

Fujieda S, Kurono Y, Okubo K, Ichimura K, Enomoto T, Kawauchi H, et al. Examination, diagnosis and classification for Japanese allergic rhinitis: Japanese guideline. Auris Nasus Larynx. 2012;39(6):553-6.

Paiva Ferreira LKD, Paiva Ferreira LAM, Monteiro TM, Bezerra GC, Bernardo LR, Piuvezam MR. Combined allergic rhinitis and asthma syndrome (CARAS). Int Immunopharmacol. 2019;74:105718.

Greiner AN, Hellings PW, Rotiroti G, Scadding GK. Allergic rhinitis. Lancet. 2011; 378(9809):2112-2122.

Khan DA. Allergic rhinitis and asthma: epidemiology and common pathophysiology. Allergy Asthma Proc. 2014;35(5):357-61.

Bousquet J, Anto JM, Bachert C, Baiardini I, Bosnic-Anticevich S, Walter Canonica G, et al. Allergic rhinitis. Nat Rev Dis Primers. 2020;6(1):95.

Pinart M, Keller T, Reich A, Fröhlich M, Cabieses B, Hohmann C, et al. Sex-Related Allergic Rhinitis Prevalence Switch from Childhood to Adulthood: A Systematic Review and Meta-Analysis. Int Arch Allergy Immunol. 2017; 172(4):224-235.

Neffen H, Mello JF Jr, Sole D, Naspitz CK, Dodero AE, Garza HL, et al. Nasal allergies in the Latin American population: results from the Allergies in Latin America survey. Allergy Asthma Proc. 2010; 31 Suppl 1:S9-27.

Ochoa-Avilés C, Morillo D, Rodriguez A, Cooper PJ, Andrade S, Molina M, et al. Prevalence and risk factors for asthma, rhinitis, eczema, and atopy among preschool children in an Andean city. PLoS One. 2020;15(7):e0236843.

Dennis RJ, Caraballo L, García E, Rojas MX, Rondon MA, Pérez A, et al. Prevalence of asthma and other allergic conditions in Colombia 2009-2010: a cross-sectional study. BMC Pulm Med. 2012;12:17.

Mancilla-Hernández E, Medina-Ávalos MA, Barnica-Alvarado RH, Soto-Candia D, Guerrero-Venegas R, Zecua-Nájera Y. Prevalence of rhinitis allergic in populations of several states of Mexico. Rev Alerg Mex 2015;62(3):196-201.

Small P, Keith PK, Kim H. Allergic rhinitis. Allergy Asthma Clin Immunol. 2018;14(Suppl 2):51.

Kakli HA, Riley TD. Allergic Rhinitis. Prim Care. 2016; 43(3):465-75.

Numminen J. Allergic rhinitis. Duodecim 2017; 133(5):473-478.

Hong SN, Won JY, Nam EC, Kim TS, Ryu YJ, Kwon JW, et al. Clinical Manifestations of Allergic Rhinitis by Age and Gender: A 12-Year Single-Center Study. Ann Otol Rhinol Laryngol. 2020;129(9):910-917.

Seidman MD, Gurgel RK, Lin SY, Schwartz SR, Baroody FM, Bonner JR, et al. Clinical practice guideline: Allergic rhinitis. Otolaryngol Head Neck Surg. 2015;152(1 Suppl):S1-43.

Eifan AO, Durham SR. Pathogenesis of rhinitis. Clin Exp Allergy. 2016;46(9):1139-5.

Voynow JA, Rubin BK. Mucins, mucus, and sputum. Chest. 2009 Feb;135(2):505-512.

Sarin S, Undem B, Sanico A, Togias A. The role of the nervous system in rhinitis. J Allergy Clin Immunol. 2006;118(5):999-1016.

Gómez F, Rondón C, Salas M, Campo P. Local allergic rhinitis: mechanisms, diagnosis and relevance for occupational rhinitis. Curr Opin Allergy Clin Immunol. 2015;15(2):111-6.

Campo P, Eguiluz-Gracia I, Bogas G, Salas M, Plaza Serón C, Pérez N, et al. Local allergic rhinitis: Implications for management. Clin Exp Allergy. 2019;49(1):6-16.

Bjermer L, Westman M, Holmström M, Wickman MC. The complex pathophysiology of allergic rhinitis: scientific rationale for the development of an alternative treatment option. Allergy Asthma Clin Immunol. 2019;15:24.

Tharpe CA, Kemp SF. Pediatric allergic rhinitis. Immunol Allergy Clin North Am. 2015;35(1):185-98.

Vardouniotis A, Doulaptsi M, Aoi N, Karatzanis A, Kawauchi H, Prokopakis E, et al. Local Allergic Rhinitis Revisited. Curr Allergy Asthma Rep. 2020;20(7):22.

Schuler Iv CF, Montejo JM. Allergic Rhinitis in Children and Adolescents. Pediatr Clin North Am. 2019;66(5):981-93.

Incorvaia C, Cavaliere C, Frati F, Maieri S. Allergic rhinitis. J Biol Regul Homeost Agents. 2018;32:61-6.

Scadding GK, Kariyawasam HH, Scadding G, Mirakian R, Buckley RJ, Dixon T, et al. BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (Revised Edition 2017; First edition 2007). Clin Exp Allergy. 2017;47(7):856-89.

Klimek L, Mullol J, Hellings P, Gevaert P, Mösges R, Fokkens W. Recent pharmacological developments in the treatment of perennial and persistent allergic rhinitis. Expert Opin Pharmacother. 2016;17(5):657-69.

Mastrorilli C, Posa D, Cipriani F, Caffarelli C. Asthma and allergic rhinitis in childhood: what's new. Pediatr Allergy Immunol. 2016;27(8):795-803.

Kawauchi H, Yanai K, Wang DY, Itahashi K, Okubo K. Antihistamines for Allergic Rhinitis Treatment from the Viewpoint of Nonsedative Properties. Int J Mol Sci. 2019;20(1):213.

Sánchez-Borges M, Ansotegui IJ. Second generation antihistamines: an update. Curr Opin Allergy Clin Immunol. 2019;19(4):358-64.

Leung TF, Wang SS, Tang MF, Kong AP, Sy HY, Hon KL, et al. Childhood asthma and spirometric indices are associated with polymorphic markers of two vitamin D 25 -hydroxylase genes. Pediatr Allergy Immunol. 2015;26(4):375-82.

Bozek A. Pharmacological Management of Allergic Rhinitis in the Elderly. Drugs Aging 2017; 34(1):21-8.

Phan H, Moeller ML, Nahata MC. Treatment of allergic rhinitis in infants and children: efficacy and safety of second-generation antihistamines and the leukotriene receptor antagonist montelukast. Drugs. 2009;69(18):2541-76.

Eguiluz-Gracia I, Pérez-Sánchez N, Bogas G, Campo P, Rondón C. How to Diagnose and Treat Local Allergic Rhinitis: A Challenge for Clinicians. J Clin Med. 2019;8(7):1062.

Yamprasert R, Chanvimalueng W, Mukkasombut, Itharat A. Ginger extract versus Loratadine in the treatment of allergic rhinitis: a randomized controlled trial. BMC Complement Med Ther. 2020;20(1):119.

Bao H, Si D, Gao L, Sun H, Shi Q, Yan Y, et al. Acupuncture for the treatment of allergic rhinitis: A systematic review protocol. Medicine (Baltimore). 2018; 97(51):e13772.

Baena-Cagnani CE. La rinitis alérgica y su impacto en el asma (ARIA) en América Latina [Allergic Rhinitis and its Impact on Asthma (ARIA) in Latin America]. Rev Alerg Mex. 2002; 49(6): 181-188.

Schaefer M, Enck P. Effects of a probiotic treatment (Enterococcus faecalis) and open-label placebo on symptoms of allergic rhinitis: study protocol for a randomised controlled trial. BMJ Open. 2019;9(10):e031339.

How to Cite
Campuzano-Revilla, G. P. (2022). Allergic Rhinitis: keys for the clinician. Mexican Journal of Medical Research ICSA, 10(19), 34-40.