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Rhinitis%20-%20nonallergic%20(pediatric) Signs and Symptoms
Introduction
- Rhinitis is the inflammation of the nasal lining membranes
Definition
- Nonallergic rhinitis is a diagnosis of rhinitis without any immunoglobulin E (IgE) mediation, as documented by allergen skin testing
Etiology
Types of Nonallergic Rhinitis
Drug-induced Rhinitis
Drug-induced Rhinitis
- May be caused by a variety of medications [eg nonsteroidal anti-inflammatory drugs (NSAIDs), Aspirin, nasal decongestants]
- Rhinitis medicamentosa is a rebound nasal congestion that results from prolonged use (5-7 days) of nasal decongestants
- Symptoms include nasal congestion & edema
- Usually presents with watery rhinorrhea that may be due to vagally mediated nasal vasodilatation that occurs within a few hours of oral ingestion
- Common triggers are hot & spicy foods
- Symptoms appear when hormonal imbalances occur (eg hypothyroidism, puberty, menstruation, oral contraceptive use or even pregnancy in adolescents)
- Usual symptoms are nasal congestion & rhinorrhea
- Usually caused by a viral infection
- Secondary bacterial infection with sinus involvement is a common complication, symptoms of which may include nasal or postnasal discharge of any quality, cough & fever
- See Rhinosinusitis - Acute Bacterial Disease Management Chart if bacterial infection is suspected
- Characterized by eosinophilia on nasal smear
- Symptoms are perennial & may consist of nasal obstruction, sneezing, rhinorrhea, nasal pruritus & hyposmia
- Rhinitis due to nasal hyperresponsiveness to a variety of nonspecific irritants, like strong odors, chemical irritants or environmental changes in temperature, humidity
- A diagnosis of exclusion
- Associated with absence of identifiable inflammation on nasal smear
Signs and Symptoms
Major signs & symptoms
- Nasal itching
- Rhinorrhea
- Nasal congestion, with or without obstruction
- Sneezing
- Headache
- Conjunctival symptoms, eye pruritus
- Pruritus of the nose, palate, ears
- Postnasal drainage
- Impaired smell
