NONALLERGIC RHINITIS - 11/09/11

Doi : 10.1016/S0889-8561(05)70234-4

Russell A. Settipane, MD ^{^{*
From Brown University School of Medicine, Providence, Rhode Island}}, Guy A. Settipane, MD ^{^{*
From Brown University School of Medicine, Providence, Rhode Island}}

Résumé

Rhinitis can be classified into allergic and nonallergic etiologies, the latter probably representing the diagnosis of as many as half the patients presenting to the physician with chronic nasal symptoms.^{42 Mullarkey M.F., Hill J.S., Webb D.R. Allergic and nonallergic rhinitis: Their characterization with attention to the meaning of nasal eosinophilia J Allergy Clini Immunol 1980 ; 65 : 122-126 [cross-ref]

Cliquez ici pour aller à la section Références}Nonallergic rhinitis is a term that is applied to a large heterogeneous group of nasal diseases which have in common the occurrence of rhinitis symptoms (obstruction/congestion, hypersecretion/rhinorrhea, and hyperirritable symptoms) without an allergic etiology. Because these symptoms are the same as those that occur in rhinitis of allergic etiology, negative testing for IgE sensitivity to all relevant aerollergens is essential to make this diagnosis.

Classification of these nonallergic rhinitis disorders may be performed on the basis of immunologic and nasal cytologic features as suggested by Zeiger^{70 Zeiger R.S. Differential diagnosis and classification of rhinosinusitis Nasal Manifestations of Systemic Diseases Providence, RI: OceanSide Publications (1991).

Cliquez ici pour aller à la section Références} (Table 1) or on the basis of etiology/systemic disease association (Table 2). Neither of these classification systems are perfect, however, because many disorders are without distinctive immunologic or cytologic features, and many disorders are without known etiology.

In order to put some limitation on the scope of this article, our discussion of nonallergic rhinitis focuses on chronic diseases of the nose, excluding acute infectious etiologies (viral upper respiratory infections and acute bacterial sinusitis). First, we briefly discuss the epidemiology of nonallergic rhinitis. Then the various syndromes that comprise this disorder are individually discussed, focusing more on the nonallergic rhinitis syndromes of common etiology and briefly reviewing uncommon or rare causes as outlined in Table 3

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