Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report

Abstract

This report has been prepared by the European Academy of Allergy and Clinical Immunology Task Force on Allergic Rhinitis (AR) comorbidities. The aim of this multidisciplinary European consensus document is to highlight the role of multimorbidities in the definition, classification, mechanisms, recommendations for diagnosis and treatment of AR, and to define the needs in this neglected area by a literature review. AR is a systemic allergic disease and is generally associated with numerous multi-morbid disorders, including asthma, eczema, food allergies, eosinophilic oesophagitis (EoE), conjunctivitis, chronic middle ear effusions, rhinosinusitis, adenoid hypertrophy, olfaction disorders, obstructive sleep apnea, disordered sleep and consequent behavioural and educational effects. This report provides up-to-date usable information to: (1) improve the knowledge and skills of allergists, so as to ultimately improve the overall quality of patient care; (2) to increase interest in this area; and (3) to present a unique contribution to the field of upper inflammatory disease.

Acoustic Rhinometry in Role of Sinus Disease and Asthma

“…Statistically, more than 50% of people with moderate to severe asthma also have chronic sinusitis indicating a direct connection between sinusitis and asthma; many studies show the connection between sinus infections and asthma [3]. One 2006 study showed that when compared with those who only have asthma, people who have both sinusitis and asthma tend to have more severe asthma symptoms, may have more severe asthma flare ups, and are more likely to have disturbed sleep [2].…”

“…The aim is to educate and implement evidence based management of allergic rhinitis in conjunction with asthma worldwide. In the ARIA guidelines revision, 2008, the published supplement in the European Journal of Allergy and Clinical Immunology reviewing the latest scientific evidence on the definition of classification of rhinitis, risk factors mechanisms, and diagnosis and treatment with extensive citations in the scientific literature states in 6.9.2 "nasal obstruction is difficult to quantify directly by examination alone", so objective assessments such as acoustic rhinometry are used as an objective assessment [3]. This specific guideline remains since the 2010 review and revision giving additional perspective on the use of various treatments for allergic rhinitis.…”

“…This specific guideline remains since the 2010 review and revision giving additional perspective on the use of various treatments for allergic rhinitis. ARIA, allergic rhinitis and its impact on asthma has not been developed only to update specialist an allergy/ immunology, otorhinolaryngology and neumology on rhinitis and its comorbidities, but, also to provide recommendations for respiratory specialists and nonspecialist such as GPs [3,6]. Other studies demonstrate the relevance of rhinometry as a valuable tool enhancing the assessment of nasal patency and better understanding nasal and respiratory physiology [4,[8][9][10][11].…”

“…In a study published in Respiratory Medicine (2003), Numminen et al [11] evaluated the reliability of acoustic rhinometry (AR) using computer tomography (CT) [3]. A total of 48 nasal cavities with nasal stuffiness associated with chronic sinusitis were measured with acoustic rhinometry (AR) and High-resolution computer tomography volumetry (HRCTV) [3]. Comparison of volumes and minimum cross-sectional areas measured with these methods was performed.…”

“…Comparison of volumes and minimum cross-sectional areas measured with these methods was performed. The volumes measured from the nostril with both methods were the anterior (0-10 mm), middle (11-40 mm) and posterior (41-70 mm) volumes [3]. The AR cross-sectional area curve was analyzed based on two minimal notches corresponding to local minimal areas.…”