-IBIS-1.7.6-
tx
immune system
hayfever syndrome
Diagnoses
definition and etiology
definition: The acute seasonal form of allergic rhinitis, recognized by sneezing, nasal discharge, nasal obstruction, itching/tearing eyes, and pruritus.
etiology: Hay fever is usually not necessarily related to hay, and is not associated with a fever. The term is used to describe the seasonal suffering of patients who are allergic to pollens (trees, weeds, grasses). Different plants pollinate at different times of the year, creating spring, summer and fall sensitivities; geographical location will often dictate when the patient will develop symptoms, by the type of foliage present there. Often, the afflicted patient is of an atopic family history: that is one of an allergic disposition, where hay fever, eczema, asthma, or urticaria is commonly seen. Food sensitivities should be considered as a causal or contributing factor with chronic hayfever.
Symptoms generally begin before the patient is 30 years old, and although they tend to diminish as the patient ages, it is uncommon for the patient to have a total remission.
signs and symptoms
The allergic manifestations are seasonal and may include:
Itchiness: Eyes, nose, roof of the mouth, throat.
Lacrimation: May or may not excoriate.
Sneezing: May occur in paroxysms.
Nasal discharge: Typically is clear and watery.
Nasal mucosa: swollen, grey/pale, boggy.
Conjunctiva are injected: conjunctivitis can occur.
Nasal obstruction may necessitate mouth-breathing.
Possible development of nasal polyps.
Worse outside, worse mowing the lawn or around flowers and trees.
Headaches, irritability, depression.
In worse disease: coughing and/or asthma may develop.
lab findings:
(+) eosinophilia.
(+) allergy testing for seasonal allergens.
Increased IgE level.
Microscopic examination of nasal smear demonstrating elevated eosinophils.
course and prognosis
The course is benign but recurrent seasonally, causing much morbidity and discomfort. Chronically suppressing the condition with antihistamines can drive the allergy deeper into the system, resulting in asthma or other problems. Conventional treatment consists of antihistamines and allergy shots.
differential diagnosis
other types of rhinitis
sinus infections
environmental toxicity
footnotes