Approach to Allergic Rhinitis.
Table of Contents
Allergic Rhinitis is the reaction of our body whenever exposed to the allergens (Pollen, Dust, Hay, Animal shedding, House dust, Mites,
Next step is to get investigated.
What are the investigations required for Allergic Rhinitis?
There are various investigations for different systems. For generalized allergy the blood investigations are:
- Differential Leukocytic Count- DLC
- Eosinophilic Sedimentation Rate- ESR
- Absolute eosinophilic count- AEC
Few investigations to rule out other diseases include:
- Chest X-Ray
- CT Scan of Nose & PNS (Sinuses Involvement)
Specific Test for allergy include:
- Skin Scratch Test:
It tests the various allergens on the skin. This test lets us know the specific allergen. It’s a provocative test so should be done with caution and proper instrumental back-up. The worst side effect of this test could be a
- RT-PCR for CK- IL4, IL17, IFN Gamma etc.
(These test are highly specific and very costly and they’re required to monitor the efficacy of treatment or disease)
What are the various treatments options for Allergic Rhinitis?
These are the drugs which reduces the symptoms of disease.
- Easily available
- Over the counter drug
- Least side effects
- It’s short-acting
- has to be taken almost daily.
- On a long term basis, patients develop resistance for the tablets. The tablets have to be regularly changed to avoid it.
Mast Cell Inhibitor:
It’s a very slow acting drug. It is more of an adjuvant rather than as a sole treatment. It should be included in treatment as it reduces the Mast cells which are responsible for allergic response in the body.
They reduces the symptoms. It’s the last line of defense against allergic rhinitis.
- Slightly long acting
- It’s effect lasts for few weeks
- Causes dryness and crusting in few patients
- Side effects are less than systemic dose but on prolonged usage it may cause side effects.
It’s a new treatment offered for Allergic conditions. It’s done after Skin Scratch test and it gradually increases the resistance of body against specific allergens.
- Sub-cutaneous Immunotherapy (SCIT)
- Sub-lingual Immunotherapy (SLIT)
- Long term relief (3-5 years)
- Tolerance induction
- Sensitization to new allergens
- Reduce Allergy progression
- Multiple Clinic sittings required
- A Costly battery of tests required
Immunotherapy is a vast topic so I’ll take it up in details in my upcoming posts. Keep hooked up to my Blog for more.
Work under progress in treatment for Allergic Rhinitis:
Purified/Recombinant Allergen & modified Vaccination.
Know more about Allergic Rhinitis, go through my previous Post ” Let’s Talk Allergies: Allergic Rhinitis”
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