Abstract
A 23 year-old female college student presents to her primary care clinic complaining of persistent runny nose and nasal congestion for more than 10 months a year over the past several years. She does not remember exactly when her symptoms began, and states that they occur daily regardless of her location or the time of day. She denies any fever, chills, mucopurulent drainage, cough, dyspnea, headache, ocular or nasal pruritis, or ocular symptoms. Past medical history shows no evidence of allergies, asthma, recurrent upper respiratory tract infections, chronic sinusitis, nasal or head trauma, or nasal surgery or trauma. She takes no medications except an occasional acetaminophen for headache when studying for several hours. She works as a part-time legal aid in an office building downtown. Family history and review of systems are unremarkable. Physical exam shows enlarged nasal turbinates, clear nasal discharge, moist and clear oropharynx with no erythema or exudates, clear tympanic membranes, no tenderness to palpation over the maxillary and frontal sinuses, and no cervical lymphadenopathy.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Settipane RA. Rhinitis: a dose of epidemiological reality. Allergy Asthma Proc 2003; 24:147–154.
Woodall BS, Meyers AD.Nonallergic rhinitis 2002. Available from: http://www.emedicine.com/ent/topic402.htm. Accessed January 15, 2005.
Dykewic MS, Fineman S. 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;81:478–518.
Settipane RA, Leiberman P. Update on nonallergic rhinitis. Ann Allergy Asthma Immunol 2001;86:494–508.
Kaline MA, Lieberman P. Incidence of allergic, nonallergic and mixed rhinitis in clinical practice. Poster presented at the annual meeting of the American Academy of Otolaryngol-ogy-Head and Neck Surgery Foundation, September 24-27, 2000.
Togias AG, Naclerio RM, Proud DF, et al. Nasal challenge with cold, dry air results in release of inflammatory mediators. Possible mast cell involvement. J Clin Invest 1985;76:1375–1381.
Togias AG, Naclerio RM, Peters SP, et al. Local generation of sulfidopeptide leukotrienes upon nasal provocation with cold, dry air. Am Rev RespirDis 1986; 133:1133–1137.
Ciprandi G. Treatment of nonallergic perennial rhinitis. Allergy 2004;59, 16–23.
Jaradeh SS, Smith TL, Torrico L, et al. Autonomic nervous system evaluation of patients with vasomotor rhinitis. Laryngoscope 2000;110:1828–1831.
oehrl TA, Smith TL, Darling RJ, et al. Autonomic dysfunction, vasomotor rhinitis, and extraesophageal manifestations of gastroesophageal reflux. Otolaryngol Head Neck Surg 2002; 126:382–387.
oehrl TA, Smith TL, Darling RJ, et al. Autonomic dysfunction, vasomotor rhinitis, and extraesophageal manifestations of gastroesophageal reflux. Otolaryngol Head Neck Surg 2002;126:382–387.
Giannessi F, Fattori B, Ursino F, et al. Ultrastructural and ultracytochemical study of human nasal respiratory epithelium in vasomotor rhinitis. Acta Otolaryngol 2003;123:943–949.
Garay R. Mechanisms of vasomotor rhinitis. Allergy 2004;59:4–10.
Groneberg DA, Heppt, W, Cryer A, et al. Toxic rhinitis-induced changes of human nasal mucosa innervation. Toxicol Pathol 2003;31:326–331.
Schierhorn K, Hanf G, Fischer A, et al. Ozone-induced release of neuropeptides fromhuman nasal mucosa cells. Int Archive Allergy Immunol 2002;129:145–151.
Ruffoli R, Fattori B, GiambellucaMA, et al. Ultracytochemical localization of the NADPH-d activity in the human nasal respiratory mucosa in vasomotor rhinitis. Laryngoscope 2000;110:1361–1365.
Lal D, Corey JP, Vasomotor rhinitis update. Allergy 2004;12:243–247.
Powe DG, Huskisson RS, Carney AS, Jenkins D, Jones NS. Evidence for an inflammatory pathophysiology in idiopathic rhinitis. Clin Exp Allergy 2001;31:864–872.
Milsevic D, Janosevic, L, Janosevic S, Invankovic Z, Dergenc R. Skin reactivity to vasomotor agents in non-eosinophilic and eosinophilic non-allergic rhinitis. J Laryngol Otol 2002;116:519–522.
Monoeret-Vautrin DA, Hsieh H, Wayoff M, Guyot JL, Mouton C, Maria Y. Non-allergic rhinitis with eosinophilia syndrome aprecursor of the triad: nasal polyposis, intrinsic asthma, and intolerance to aspirin. Ann Allergy 1990;64:513–518.
Leone C, Teodoro C, Pelucchi A, et al. Bronchial responsiveness and airway inflammation in patients with nonallergic rhinitis with eosinophila syndrome. J Allergy Clin Immunol 1997; 100:775–780.
Settipane RA, Lieberman P. Update on non-allergic rhinitis. Ann Allergy Asthma Immunol 2001;86:494–507.
Bush RK, Asbury DW. Aspirin-sensitive asthma. In: Busse WW, Holgate ST, eds. Asthma and Rhinitis, 2nd ed. Blackwell Science Ltd., Oxford, 2000;pp. 1315–1325.
Bachert C. Persistent rhinitis-allergic or nonallergic? Allergy 2004;59:11–15.
van Cauwenberge PB, Wang D-Y, Ingels KJAO, Bachert C. Rhinitis: the spectrum of the disease. In: Busse WW, Holgate ST, eds. Asthma and Rhinitis, 2nd ed. Blackwell Science Ltd., Oxford, 2000; pp. 6–13.
Tunnicliffe WS, O’Hickey SP, Fletcher TJ, Miles TF, Burge PS, Ayres JG. Pulmonary function and respiratory symptoms in a population of airport workers. Occup Environ Med 1999;56:118–123.
Ellegard E, Hellgren M, Toren K, Karlsson G. The incidence of pregnancy rhinitis. Gynecol Obstet Invest 2000;49:98–101.
Mastin T. Recognizing and treating non-infectious rhinitis. J Am Acad Nurse Pract 2003;15:398–409.
Hamano N, Terada N, Maesako K, et al. Expression of histamine receptors in nasal epithelial cells and endothelial cells-the effects of sex hormones. Int Arch Allergy Immunol 1998:115:220–227.
Hamano N, Terada N, Maesako K, Numata T, Konno A. Effect of sex hormones on eosino-philic inflammation in nasal mucosa. Allergy Asthma Proc 1998;19:263–269.
Settipane GA, Klein DE. Nonallergic rhinitis: demography of eosinophils in nasal smear, blood total eosinophil counts, and IgE levels. N Engl Reg Allergy Proc 1985;6:363–366.
Collins JG. Prevalence of selected chronic conditions, United States, 1983-1985. National Center for Health Statistics Advance Data 1988;155:1–16.
Bjorksten B. Risk factors in early childhood for the development of atopic disease. Allergy 1994;49:400–407.
Lieberman P. Rhinitis. In: Bone RC, ed. Current Practice of Medicine. Current Medicine, Philadelphia, PA, 1996, pp. 1756–1765.
Settipane GA. Rhinitis: introduction. In: Settipane GA, ed. Rhinitis. Oceanside: Providence, RI, 1991.
Lieberman P, Rakel RE, Hedges HH III, et al. Quantifying the incidence of mixed rhinitis with a new patient screening tool. Today’s Therapeutic Trends 2005;20:221–232.
Lieberman P. Rhinitis. In: Slavin RG, Reisman RE, eds. Expert Guide to Allergy and Immunology. Philadelphia: American College of Physicians: 1999, pp. 23–40.
Management of Allergic and Nonallergic Rhinitis. Summary, evidence report/technology assessment: No. 54, May 2002. Agency for Healthcare Research and Quality, Rockville, MD. Available from: http://www.ahrq.gov/clinic/epcsums/rhinsum.htm.
Lau J, Long A. Chronic rhinitis: allergic or non-allergic? AmFam Physician 2003;67:705–706.
Banov CH, Lieberman P. Efficacy of azelastine nasal spray in the treatment of vasomotor (perennial non-allergic) rhinitis. Ann Allergy Asthma Immunol 2001;86:28–35.
Gehanno P, Deschamps E, Garay E, Baehre M, Garay RP. Vasomotor rhinitis: clinical efficacy of azelastine nasal spray in comparison with placebo. ORL J OtorhinolaryngolRelat Spec 2001;63:85–141.
cadding GK. Clinicalassessment of antihistaminesin rhinitis.ClinExp Allergy 1999;29:77–81.
Lieberman PL, Settipane RA. Azelastine nasal spray: a review of pharmacology and clinical efficacy in allergic and non-allergic rhinitis. Allergy Asthma Proc 2003;24:95–105.
Borish L. The role of leukotrienes in upper and lower airway inflammation and the implications for treatment. Ann Allergy Asthma Immunol 2002;88:16–22.
Prasanna A, Murthy PSN. Vasomotor rhinitis and sphenopalatine ganglion block. J Pain Symptom Manage 1997;13:332–338.
Hadley JA. Vasomotor rhinitis remains a true clinical problem. Arch Otolaryngol Head Neck Surg 2003;129:587–588.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2006 Humana Press Inc., Totowa, NJ
About this chapter
Cite this chapter
Bell, C., Mintz, M.L. (2006). Non-Allergic Rhinitis. In: Mintz, M.L. (eds) Disorders of the Respiratory Tract. Current Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-59745-041-6_5
Download citation
DOI: https://doi.org/10.1007/978-1-59745-041-6_5
Publisher Name: Humana Press
Print ISBN: 978-1-58829-556-9
Online ISBN: 978-1-59745-041-6
eBook Packages: MedicineMedicine (R0)