Clinical features

Allergic rhinitis is characterised by rhinorrhoea, nasal blockage and sneezing attacks for longer than 1 hour per day lasting for 2 weeks.

More detailed information concerning clinical features is presented below:

• nasal blockage—intermittent, alternating unilateral blockage—a persistent unilateral blockage may indicate a mechanical cause e.g., septum deviation, nasal polyp
• sneezing—often paroxysmal (1)
• nasal itching
• rhinorrhoea—can be anterior resulting in persistent sniffing and nose-blowing, or posterior resulting in postnasal drip; if there is unilateral rhinorrhoea in an adult, this should alert the clinician to the possibility of cerebrospinal fluid
• unilateral rhinorrhoea in a child may be secondary to a foreign body
• epiphora, reddening of conjunctivae, swelling of eyelids
• reduced taste or smell
• headaches—often without sinusitis; the pain may be referred to the forehead, lateral to nose, around the eye or over the cheeks
• reduced hearing due to eustachian tube dysfunction

Signs may include:

• oedematous nasal mucosa, often blue
• clear nasal discharge
• nasal crease or nasal salute, especially in children

Reference:

1. Eifan AO, Durham SR. Pathogenesis of rhinitis. Clin Exp Allergy. 2016;46(9):1139–51.