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Allergy Rhinoconjunctivitis

Carmen Rondón MD, PhD. Allergist, Allergy Unit, Regional University Hospital of Malaga, IBIMA, Malaga University, Malaga, Spain, This email address is being protected from spambots. You need JavaScript enabled to view it.
Cemal Cingi MD, PhD. Eskisehir Osmangazi University, ENT Dept. Eskisehir - Turkey, This email address is being protected from spambots. You need JavaScript enabled to view it.

Allergic rhinoconjunctivitis (ARC) is the most frequent allergic disease.  In the recent four decades its prevalence has dramatically increased in both industrialized countries and countries in process of development. It is a global health problem that may affects up to 40% of the population of all countries, ethnic groups and ages, with impairment of their quality of life and frequent association to other respiratory diseases such as asthma, rhinosinusitis, and otitis.

Allergy RhinoconjunctivitisIt is an inflammatory disorder of the nasal and conjunctival mucosa induced by a hypersensitivity immune response directed against an allergen to which the subject is previously sensitized. This means that in subjects with ARC your immune system mistakenly identifies a typically harmless substance as an intruder.  This substance is called an allergen. In this situation the immune system responds to the allergen by releasing histamine and chemical mediators that typically cause symptoms of allergic rhinitis: itchy nose, sneezing, watery mucus and usually nasal congestion or blockage, and conjunctivitis: itching/burning eyes, tearing and redness.

Allergic rhinitis (AR) is classified according to the time of exposure to the allergen in seasonal and perennial. Seasonal ARC (hay fever) is usually caused by allergy to pollen carried in the air. On the other hand perennial can be triggered by common indoor allergens such as the dried skin flakes, urine and saliva found on dust mites and cockroach particles that are present in the air round-year.

New Insights in Diagnosis and Treatment

In the past the diagnosis of allergic rhinitis was commonly confirmed by skin and blood allergy test including determination of specific IgE antibodies in serum. In the recent years, the description of a new form of local allergic rhinitis (LAR) with negative skin and blood allergy tests in more than 25% of subject suffering from rhinitis has made change the way of diagnosis allergy in rhinitis patients. Nowadays the diagnostic approach must include an advanced nasal allergy study in those patients with clinical symptoms suggestive of AR when skin and blood allergy test are negative in order to indentify the presence of LAR.

Allergy RhinoconjunctivitisThe best way to treat an allergy condition is to identify the allergen responsible, avoid it when is possible, perform a specific immunotherapy with the sensitizing allergen, and improve the symptoms with medication.

The nose represents the first place of interaction between allergens carried in the air and the immune system.  It is important to understand that allergic rhinitis and asthma are two expressions of the same disease and a good control of allergic rhinitis leads towards a good control of allergic asthma. It is therefore important to make an early diagnosis of allergic rhinitis that allows implementing measures to avoid exposure to allergens and start a specific immunotherapy, which modifies the natural course of the disease, shots achieves significantly reduce symptoms, the development of asthma and the appearance of new sensitization in patients. The improvement achieved by a course of three to five years of specific immunotherapy is generally maintained for many years after completion of treatment.

Learning to avoid exposure to allergens

- Pollens allergy:  As a general measure, should avoid prolonged stay and physical activity in parks, gardens and wooded areas, trying to stay as long as possible in clean interiors, especially when windy. Keep windows closed usually your bedroom, except when aerate. It is advisable to ventilate the room and make the evening water sprays before bedtime. If traveling by car keep the windows closed to avoid the impact of the air on the face. The filters incorporating the air conditioning system can help prevent pollen from entering the passenger compartment.

Allergy Rhinoconjunctivitis- Mites allergy: It is recommended to remove carpets or rugs, prevent accumulation of blankets, stuffed animals and books in excess in the bedroom. It is also advisable to dispense with the use of wool mattresses and pillows. To cover mattresses and pillows with a waterproof protector mites and wash the sheets and blankets weekly in hot water is recommended.

It is advisable to maintain a relative humidity below 60%, avoiding the use of environmental humidifiers. Prolonged stay in wet environments and places that have been closed for a long time (basements, cellars, storage rooms, etc..) should also be avoided.

 - Molds allergy: Molds are fungi that reproduce by spores small floating in the air. Molds need four things to grow: food, air, water and a suitable temperature. They can live both outdoors and inside homes and other buildings.

In closed areas are often concentrated in areas where more moisture (basements, storage rooms, cellars, etc..) Accumulates. Indoor pools are an important source of exposure to fungal spores.

In the patient's home is advisable to maintain a relative humidity below 60%, avoiding the use of environmental humidifiers. If you have air conditioning, clean it frequently and regularly change the water filter.

It is advisable to avoid prolonged stay in wet environments and places that have been closed for a long time and excess plants or dense vegetation on terraces and windows, montoneras wood and dried leaves

Allergy Rhinoconjunctivitis- Pet allergy: The proteins found in a pet's dander, skin flakes, saliva and urine can be a direct cause of allergic rhinitis and asthma, and also pet hair or fur can collect pollen, mold spores, and mites aggravating the symptoms of allergic subjects.

Allergy to pet dander is one of the more frequent and intense allergies. In the case of cat dander allergy, symptoms of rhino-conjunctivitis and asthma can appear simply to be near cat owners that carry allergens on your clothes, not necessarily being this cat. Besides the pet dander can remain floating in the air inside the homes of allergy sufferers several months after you stop having a pet.

There are really no "hypoallergenic breeds" of dogs or cats. Allergy to cat dander and dogs do not depend on the length of hair, or by the amount of shedding.

But fortunately allergy to cat, dog and horse dander it is one of the best controlled with specific immunotherapy. As suspected allergy to pet dander is recommended to consult an allergist who will conduct an appropriate diagnosis and specific treatment for your allergy, without it being necessary to give up your pet.