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Nasobronchial interaction in allergic rhinitis and asthma
- Publication date
- 20 June 2001
- Publisher
- The key to the diagnosis lies in taking a good medical history. This rule especially
applies to allergic rhinitis and asthma. Both diseases have in common that they are
often underdiagnosedl and lack proper treatment. Allergic rhinitis and asthma
frequently occur together. Almost 40 % of the allergic rhinitis patients have lower
airways involvement, whereas more than 80 % of the allergic asthma patients have
concomitant rhinitis symptoms. The latter percentage gets close to 95 % when a
careful nasal history is taken and physical examination is performed.
Allergic asthma is characterized by a history of episodes of cough, dyspnea, shortness
of breath, chest tightness and wheezing, in combination with variable
bronchoconstriction and/or bronchial hyperresponsiveness (BRR). Mucosal
inflammation is also considered an important hallmark of asthma6. However, the
associations between mucosal inflammation and clinical parameters, such as variable
airflow obstruction and BRR, are still controversia.
Allergic rhinitis is primarily based on a typical history of sneezing, rhinorrhoea, eye
symptoms and nasal obstruction. As in allergic asthma, the atopic status needs to be
confirme<f4. In perennial rhinitis, chronic nasal obstruction can sometimes be
the only symptom, which makes it difficult to confIrm the diagnosis. The diagnosis of
seasonal allergic rhinitis is less disputable, the symptomatology and seasonal
occurrence are characteristic and have been well established for many years. The
distinction between allergic asthma and rhinitis is sometimes difficult to make since
symptom perception is widely variable; lung function can be normal in mild
asthmatics and, although BHR is a constant feature of asthma, it is also frequently
present in allergic rhinitis.