Allergic rhinitis is the most common nasal problem and the sixth most common chronic disease in the United States, affecting more than 15% of Americans.<sup>2 Adams PF, Marano MA: Current estimates from the National Interview Survey: 1994. Vital and Health Statistics. Hyattsville, MD, US Department of Health and Human Services, National Center for Health Statistics, 1995. Pub. No. 96-1521. Series 10: No. 193

Cliccare qui per andare alla sezione Riferimenti, 10 Collins JG: Prevalence of selected chronic conditions: United States: 1983–1985. Hyattsville, MD, US Department of Health and Human Services, National Center for Health Statistics, 1988. Advance Data From Vital and Health Statistics, 1988. Pub. No. 88-1250. No. 155

Cliccare qui per andare alla sezione Riferimenti</sup> Although many view the symptoms of allergic rhinitis as a nuisance, quality-of-life studies suggest that affected patients may experience significant impairment in function.<sup>23 Juniper E.F., Guyatt G.H. Developing and testing of a new measure of health status for clinical trials in rhinoconjunctivitis Clin Exp Allergy 1991 ;  21 : 77-83  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 24 Juniper E.F., Guyatt G.H., Anderson B. , e al. Comparison of powder and aerosolized budesonide in perennial rhinitis: Validation of rhinitis quality-of-life questionnaire Annals of Allergy 1993 ;  70 : 225-230

Cliccare qui per andare alla sezione Riferimenti</sup> This impairment frequently limits performance of routine daily activities.

The annual economic impact of allergic rhinitis in the United States is impressive: nearly $1.5 billion spent for physician office visits and medications. Allergic rhinitis accounts for 3.5 million lost work days and over 2 million missed school days. The combined impact of health care services and lost productivity is estimated at $5.6 billion annually.<sup>40 Ross R.N. The costs of allergic rhinitis Am J Managed Care 1996 ;  2 : 285-290

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Based on the current understanding of pathophysiology, allergic rhinitis is an inflammatory disorder driven by T_H2 lymphocytes. This process directs production of specific IgE and involves B lymphocytes, eosinophils, mast cells, and various cytokines and mediators. Appreciation of this pathway has led to an array of more effective medications and novel forms of immunomodulatory therapy.

For clinicians treating patients with nasal symptoms, the diagnosis of allergic rhinitis is often suspected after a careful history. Supportive data include a suggestive nasal examination and nasal cytology. The presence of specific IgE is determined by appropriate skin tests or rarely radioallergosorbent tests. The results of these tests form the basis of environmental control and occasionally immunotherapy in concert with contemporary pharmacotherapy. With comprehensive therapy, the allergic rhinitis patient of the new millenium realistically should expect control of symptoms, enhanced quality of life, and reduced risk for asthma, otitis media, and sinusitis.