rhinitis%20-%20nonallergic
RHINITIS - NONALLERGIC
Treatment Guideline Chart
Nonallergic rhinitis is the inflammation of the nasal lining membranes without any immunoglobulin E mediation, as documented by allergen skin testing.
Major signs and symptoms include nasal itching, watery rhinorrhea, nasal obstruction/congestion, sneezing and postnasal drainage.
Symptoms can reverse spontaneously with or without treatment.

Rhinitis - Nonallergic References

  1. Angier E, Willington J, Scadding G, et al; British Society for Allergy & Clinical Immunology (BSACI) Standards of Care Committee. Management of allergic and non-allergic rhinitis: a primary care summary of the BSACI guideline. Prim Care Respir J. 2010 Sep;19(3):217-222. doi: 10.4104/pcrj.2010.00044. PMID: 20680237
  2. Bousquet J, Khaltaev N, Cruz AA, et al; World Health Organization; GA(2)LEN; Allergen. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008 Apr;63(Suppl 86):008-160. http://www.ncbi.nlm.nih.gov/pubmed/?term=18331513. PMID: 18331513
  3. Bousquet J, Van Cauwenberge, Khaltaev N, et al. ARIA in the pharmacy: management of allergic rhinitis symptoms in the pharmacy. Allergic rhinitis and its impact on asthma. Allergy. 2004 Apr;59(4):373-387. PMID: 15005760
  4. Clark AT, Cullinan P, Dizon TA, et al. BSACI guideline for the management of allergic and non-allergic rhinitis. Clin Exp Allergy. 2008 Jan;38(1):19-42. doi: 10.1111/j.1365-2222.2007.02888. Accessed 16 Aug 2010. PMID: 18081563
  5. Dykewicz MS, Wallace DV, et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008 Aug;122(Suppl 2 Suppl):S1-S84. http://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/rhinitis2008-diagnosis-management.pdf. Accessed 16 Aug 2010. PMID: 18662584
  6. Dykewicz MS, Fineman S, Nicklas R, et al. Joint Task Force algorithm and annotations for diagnosis and management of rhinitis. Ann Allergy Asthma Immunol. 1998 Nov;81(5)(Suppl Pt 2):469-473. Accessed 30 May 2002. PMID: 9860025
  7. Dykewixz MS, Fineman S. Executive summary of joint task force practice parameters on diagnosis and management of rhinitis. Ann Allergy Asthma Immunol. 1998 Nov;81(5 Pt 2):463-468. doi: 10.1016/S1081-1206(10)63152-3. Accessed 30 May 2002. PMID: 9860024
  8. Dykewixz MS, Fineman S, Skoner DP. Joint Task Force summary statements on diagnosis and management of rhinitis. Ann Allergy Asthma Immunol. 1998 Nov;81(5)(Pt 2):474-477. PMID: 9860026
  9. Nayak A. A review of montelukast in the treatment of asthma and allergic rhinitis. Expert Opin Pharmacother. 2004 Mar;5(3):679-686. http://www.ncbi.nlm.nih.gov/pubmed/15013935. PMID: 15013935
  10. Van Cauwenberge P, Bachert C, Passalacqua G, et al. Consensus statement on the treatment of allergic rhinitis. European Academy of Allergology and Clinical Immunology. Allergy. 2000 Feb;55(2):116-134. doi: 10.1034/j.1398-9995.2000.00526.x. PMID: 10726726
  11. Wallace DV, Dykewicz MS, Bernstein DI, et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008 Aug;122(Suppl 2):S1-S84. doi: 10.1016/j.jaci.2008.06.003. PMID: 18662584
  12. Dykewicz MS. Rhinitis and sinusitis. J Allergy Clin Immunol. 2003 Feb;111(2):S520-S529. http://www.jacionline.org/. PMID: 12592298
  13. Dykewicz MS, Fineman S, Skoner DP, et al. Diagnosis and management of rhinitis: complete guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology. Ann Allergy Asthma Immunol. 1998 Nov;81:478-518. PMID: 9860027
  14. Greiner AN, Meltzer EO. Pharmacologic rationale for treating allergic and nonallergic rhinitis. Sep 18, 2006. J Allergy Clin Immunol. 2006 Nov;118(5):985-996. http://www.jacionline.org/article/S0091-6749(06)01380-7/pdf. PMID: 17088121
  15. Quillen DM, Feller DB. Diagnosing rhinitis: allergic vs. nonallergic. Am Fam Physician. 2006 May;73(9):1583-1590. PMID: 16719251
  16. Vassallo K. Rhinitis in general practice. Malta Med J. 2007 Sep;19(3):41-46
  17. Murray JF, Nadel JA. Disorders of the upper airways. Textbook of respiratory Medicine. 3rd ed. St Louis: W.B. Saunders Company; 2000:1346-1350
  18. MedWormhttp://www.medworm.com/rss/index.php/Pediatrics/33/http://www.medworm.com/rss/medicalfeeds/specialities/Pediatrics.xml
  19. MedWormhttp://www.medworm.com/rss/index.php/Respiratory-Medicine/40/http://www.medworm.com/rss/medicalfeeds/specialities/Respiratory-Medicine.xml
  20. CKS. Allergic rhinitis. Clinical Knowledge Summaries. http://cks.library.nhs.uk/. 2005.
  21. Institute for Clinical Systems Improvement (ICSI). Health care guideline: diagnosis and treatment of respiratory illness in children and adults. ICSI. http://www.icsi.org. Jan 2008. Accessed 16 Aug 2010.
  22. Dykewixz MS, Fineman S, Nicklas R. Joint Task Force algorithm and annotations for diagnosis and management of rhinitis. http://www.jcaai.org/param/rhinitis/algorithm.htm. 1998. Accessed 30 May 2002
  23. American Academy of Allergy, Asthma and Immunology. The allergy report: diseases of the atopic diathesis. AAAAI. http://www.aaaai.org/.
  24. Scadding G. 2007 Annual evidence update on rhinitis: nonallergic rhinitis. Guideline summary - non-allergic rhinitis. National Health Service (NHS) Evidence - ENT and audiology. http://www.library.nhs.uk/ent/ViewResource.aspx?resID=260110. May 2007. Accessed 17 Aug 2010
  25. Grossman J. Update on allergic and infectious rhinitis. New York City, USA. AAPA 24th Annual Conference. 29 May 1996.
  26. University of Michigan Health System. Guidelines for clinical care: allergic rhinitis. http://cme.med.umich.edu/pdf/guideline/allergic.pdf. 2002. Accessed 15 Mar 2005
  27. New England Medical Center Evidence-based Practice Center. Management of Allergic and Nonallergic Rhinitis. Agency for Healthcare Research and Quality. http://archive.ahrq.gov/downloads/pub/evidence/pdf/rhinitis/rhinitis.pdf. May 2002
  28. Meyers AD, Ramakrishnan VJ. Non-allergic rhinitis. eMedicine. http://emedicine.medscape.com/article/874171-overview. Apr 2010. Accessed 17 Aug 2010.
  29. Woodall BS, Meyers AD. Nonallergic rhinitis. eMedicine. http://www.emedicine.com/ent/topic402.htm. 2002. Accessed 15 Apr 2005
  30. Lieberman PL. Chronic nonallergic rhinitis. UpToDate. http://www.uptodate.com/contents/chronic-nonallergic-rhinitis?source=see_link. 08 Apr 2013. Accessed 18 Mar 2014.
  31. Ramakrishnan VR. Pharmacotherapy for nonallergic rhinitis. eMedicine. http://emedicine.medscape.com/article/874171-overview#showall. 10 Dec 2013. Accessed 14 Mar 2014.
  32. Settipane RA, Lieberman P. Update on nonallergic rhinitis. Ann Allergy Asthma Immunol. 2001 May;86(5):494-507. doi: http://dx.doi.org/10.1016/S1081-1206(10)62896-7. Accessed 20 Apr 2015. PMID: 11379801
  33. Scadding GK, Kariyawasam HH, Scadding G, 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 May;47:856-889. doi: 10.1111/cea.12953. Accessed 14 Sep 2018
  34. Fried MP. Nonallergic rhinitis. MSD Manual. https://www.msdmanuals.com/. 2019.
  35. Hellings PW, Klimek L, Cingi C, et al. Non-allergic rhinitis: Position paper of the European Academy of Allergy and Clinical Immunology. Allergy. 2017 Nov;72(11):1657-1665. doi: 10.1111/all.13200. PMID: 28474799
  36. Lieberman PL. Chronic nonallergic rhinitis. UptoDate. https://www.uptodate.com/. Jun 2019.
  37. Lieberman PL. Patient education: Nonallergic rhinitis (runny or stuffy nose) (Beyond the Basics). UptoDate. https://www.uptodate.com/. Jun 2019.
  38. Scarupa MD, Kaliner MA. Nonallergic rhinitis, with a focus on vasomotor rhinitis: clinical importance, differential diagnosis, and effective treatment recommendations. World Allergy Organ J. 2009 Mar;2(3):20-25. doi: 10.1097/WOX.0b013e3181990aac. PMID: 23282951
  39. Dykewicz MS, Wallace DV, Amrol DJ, et al. Rhinitis 2020: a practice parameter update. J Allergy Clin Immunol. 2020 Oct;146(4):721-767. doi: 10.1016/j.jaci.2020.07.007. Accessed 24 Aug 2021. PMID: 32707227
  40. Beard S. Rhinitis. In: Kellerman RD, Rakel D, eds. Conn's Current Therapy 2021. Philadelphia: Elsevier; 2021. 53-57. :53-57.
  41. ClinicalKey. Non-allergic rhinitis. ClinicalKey. https://www.clinicalkey.com. 02 Jul 2021.
  42. Yan CH, Hwang PH. Nonallergic rhinitis. In: Flint PW, Haughey BH, Lund VJ, et al. Cummings Otolaryngology: Head and Neck Surgery 2021. Philadelphia: Elsevier; 2021. 636-642.e2. :636-642.e2.
  43. Yum HY, Ha EK, Shin YH, et al. Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis. Clin Exp Pediatr. 2021 Aug;64(8):373-383. doi: 10.3345/cep.2020.00822. PMID: 32777916
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