Niealergiczne zapalenie błony śluzowej nosa

Niealergiczne zapalenie błony śluzowej nosa
Epidemiologia

Niealergiczny nieżyt nosa (NAR) stanowi istotny problem zdrowotny o zróżnicowanym rozpowszechnieniu, szacowanym na 7-28% populacji ogólnej, co odpowiada 17-52% wszystkich przypadków nieżytu nosa. Epidemiologia NAR charakteryzuje się znaczną zmiennością geograficzną oraz wiekową, z dominacją u dorosłych kobiet (58-71%) i rzadkim występowaniem u dzieci, gdzie stosunek NAR do alergicznego nieżytu nosa (AR) wynosi około 1:3-4. Najczęstszym fenotypem NAR jest naczynioruchowy nieżyt nosa (vasomotor rhinitis), stanowiący około 71% przypadków, dotykający około 14 milionów Amerykanów i szacowany globalnie na 320 milionów osób. Inne ważne fenotypy to nieżyt nosa wywołany lekami (17% przypadków) oraz NARES (non-allergic rhinitis with eosinophilia syndrome). Występuje także miejscowy alergiczny nieżyt nosa (LAR), diagnozowany za pomocą donosowego testu prowokacji alergenem (NAPT), z częstością 25,7% w populacji z nieżytem nosa. NAR często współistnieje z astmą, chorobą refluksową oraz innymi schorzeniami układu oddechowego, co wpływa na przebieg kliniczny i wymaga kompleksowego podejścia terapeutycznego.

Epidemiologia niealergicznego nieżytu nosa – przegląd

Rozpowszechnienie niealergicznego nieżytu nosa w populacji ogólnej
Globalny wymiar problemu
Zróżnicowanie wiekowe i płciowe w występowaniu NAR
Niealergiczny nieżyt nosa u dzieci
Nieżyt nosa mieszany (Mixed Rhinitis)

Epidemiologia fenotypów niealergicznego nieżytu nosa

Naczynioruchowy nieżyt nosa (Vasomotor Rhinitis)
Nieżyt nosa wywołany lekami (Rhinitis Medicamentosa)
Niealergiczny nieżyt nosa z zespołem eozynofilii (NARES)
Miejscowy alergiczny nieżyt nosa (Local Allergic Rhinitis)

Trendy czasowe w epidemiologii niealergicznego nieżytu nosa

Wzrost częstości występowania nieżytu nosa
Zróżnicowanie geograficzne

Choroby współistniejące i czynniki ryzyka

Astma
Inne choroby współistniejące
Choroba refluksowa

Obciążenie ekonomiczne i wpływ na jakość życia

Wpływ na jakość życia
Koszty ekonomiczne

Monitoring i diagnostyka niealergicznego nieżytu nosa

Wyzwania diagnostyczne
Ulepszone metody diagnostyczne
Luki w monitorowaniu

Przyszłe kierunki badań nad epidemiologią niealergicznego nieżytu nosa

Potrzeba standaryzowanej definicji
Badania nad fenotypami
Zapobieganie fenotypom możliwym do uniknięcia
Badania pediatryczne
Kolejne rozdziały

Epidemiologia niealergicznego nieżytu nosa – przegląd

Niealergiczny nieżyt nosa (Non-allergic rhinitis, NAR) stanowi istotny problem zdrowotny na całym świecie, choć jego dokładna epidemiologia jest trudna do precyzyjnego określenia. Trudności w ocenie rozpowszechnienia NAR wynikają z kilku czynników: braku standaryzowanej definicji, trudności diagnostycznych, nakładania się objawów z alergicznym nieżytem nosa (AR) oraz występowania mieszanych form nieżytu nosa¹². Mimo tych ograniczeń, badania epidemiologiczne dostarczają cennych informacji na temat rozpowszechnienia niealergicznego nieżytu nosa w populacji ogólnej.

Rozpowszechnienie niealergicznego nieżytu nosa w populacji ogólnej

Przewlekły nieżyt nosa (zarówno alergiczny, jak i niealergiczny) dotyka znacznej części populacji ogólnej. Według różnych badań, rozpowszechnienie przewlekłego nieżytu nosa w populacji ogólnej wynosi od 10% do 40%³. W jednym z badań przekrojowych stwierdzono, że częstość występowania przewlekłego nieżytu nosa w populacji ogólnej wynosi 40%, z czego 65% przypadków stanowi NAR, a 28% – AR (w 7% przypadków status alergii pozostaje nieznany)⁴.

Szacuje się, że NAR dotyka około 7-28% populacji ogólnej⁵⁶. Niealergiczny nieżyt nosa stanowi od 17% do 52% wszystkich przypadków nieżytu nosa⁷. W badaniach przeprowadzonych w Omanie stwierdzono, że NAR stanowi 57% populacji z nieżytem nosa, co jest zbliżone do danych z literatury światowej⁸.

Warto zauważyć, że istnieje znaczna zmienność geograficzna w rozpowszechnieniu NAR. W badaniu przeprowadzonym w wiejskich obszarach północnych Chin, standaryzowane rozpowszechnienie NAR wynosiło 24,60%, podczas gdy AR – 16,78%⁹. Natomiast w Stanach Zjednoczonych szacuje się, że około 19-20 milionów osób cierpi na niealergiczny nieżyt nosa¹⁰¹¹.

Globalny wymiar problemu

Badania epidemiologiczne wskazują, że NAR może dotykać ponad 200 milionów osób na całym świecie¹². Niektóre szacunki sugerują, że sama postać naczynioruchowa nieżytu nosa (vasomotor rhinitis), która jest najczęstszą postacią NAR, dotyka około 14 milionów Amerykanów, a jej globalne rozpowszechnienie może sięgać 320 milionów osób¹³¹⁴.

W Europie szacuje się, że NAR może dotykać nawet 50 milionów osób¹⁵. Badania wykazały, że od 25% do 50% pacjentów z nieżytem nosa cierpi na NAR, co stanowi znaczącą część populacji z tą dolegliwością¹⁶.

Zróżnicowanie wiekowe i płciowe w występowaniu NAR

Niealergiczny nieżyt nosa występuje zazwyczaj później niż alergiczny nieżyt nosa. Podczas gdy AR rozwija się przed 20 rokiem życia w 80% przypadków¹⁷, NAR najczęściej występuje po 20 roku życia, a 70% pacjentów z NAR zgłasza się po raz pierwszy po ukończeniu 20 lat¹⁸. Typowy wiek występowania NAR mieści się w przedziale między 30 a 60 rokiem życia¹⁹²⁰.

W populacji dorosłych NAR wykazuje wyraźną przewagę u kobiet, z szacunkami wskazującymi, że 58-71% osób dotkniętych tą chorobą to kobiety²¹. Niektóre badania wskazują nawet na stosunek 2:1 do 3:1 na korzyść kobiet²².

Niealergiczny nieżyt nosa u dzieci

NAR jest stosunkowo rzadki u dzieci w porównaniu z dorosłymi. Dokładne rozpowszechnienie NAR w populacji pediatrycznej nie jest dobrze zbadane²³, ale szacuje się, że stosunek częstości występowania NAR do AR u dzieci wynosi co najmniej 1:3-4²⁴.

Badania wskazują, że NAR stanowi od 15,7% do 89,0% przypadków przewlekłego nieżytu nosa u dzieci, dotykając od 0,7% do 50,0% (mediana 10,1%) całkowitej populacji pediatrycznej²⁵²⁶.

Ciekawą obserwacją jest to, że NAR jest bardziej rozpowszechniony w pierwszych 2 latach życia, ale jego odsetek maleje wraz z wiekiem, podczas gdy odsetek AR wzrasta²⁷. W badaniu kohortowym z Wielkiej Brytanii zaobserwowano malejący trend w proporcji dzieci z objawowym nieżytem nosa: 79%, 45% i 42,3% odpowiednio w wieku 2, 4 i 10 lat²⁸. Podobnie, w niedawnym badaniu populacji koreańskiej stwierdzono, że rozpowszechnienie alergicznego nieżytu nosa wzrosło z 22,1% do 28,3% w przedziale wiekowym od 7 do 12 lat, podczas gdy rozpowszechnienie niealergicznego nieżytu nosa zmniejszyło się z 21,3% do 13,3%²⁹.

Nieżyt nosa mieszany (Mixed Rhinitis)

Istotnym zjawiskiem w epidemiologii nieżytu nosa jest nakładanie się alergicznego i niealergicznego nieżytu nosa, określane jako nieżyt nosa mieszany (mixed rhinitis). Według badań, około 44% pacjentów z alergicznym nieżytem nosa może mieć jednocześnie niealergiczny nieżyt nosa³⁰. W Stanach Zjednoczonych szacuje się, że dodatkowe 26 milionów osób ma niealergiczny komponent w swoim nieżycie nosa, co daje łącznie około 45 milionów osób z czystym niealergicznym nieżytem nosa lub mieszanym nieżytem nosa³¹³².

Badania przeprowadzone w poradniach alergologicznych wykazały, że 23% pacjentów z nieżytem nosa miało postać niealergiczną, 43% – alergiczną, a 34% – mieszaną³³. Inne badania sugerują, że nawet 50-80% pacjentów z nieżytem nosa może mieć NAR, czy to w postaci czystej, czy częściej jako chorobę mieszaną z pewną formą AR³⁴.

Epidemiologia fenotypów niealergicznego nieżytu nosa

Niealergiczny nieżyt nosa nie jest jednorodną jednostką chorobową, ale obejmuje szereg różnych podtypów i fenotypów. Badania epidemiologiczne dotyczące poszczególnych fenotypów NAR są ograniczone, ale dostarczają pewnych informacji na temat ich względnej częstości występowania.

Naczynioruchowy nieżyt nosa (Vasomotor Rhinitis)

Naczynioruchowy nieżyt nosa (vasomotor rhinitis) jest najczęstszą postacią niealergicznego nieżytu nosa, stanowiąc około 71% wszystkich przypadków NAR³⁵³⁶. W Stanach Zjednoczonych szacuje się, że około 14 milionów osób cierpi na naczynioruchowy nieżyt nosa³⁷.

Ta postać NAR dotyka od 15% do połowy wszystkich przypadków nieżytu nosa w krajach uprzemysłowionych³⁸. Badania Mullarkeya, Enberga i Settipane jednogłośnie potwierdzają, że naczynioruchowy nieżyt nosa jest najczęstszym podtypem NAR³⁹.

Nieżyt nosa wywołany lekami (Rhinitis Medicamentosa)

Drugim najczęstszym fenotypem NAR jest nieżyt nosa wywołany lekami (rhinitis medicamentosa), który stanowi około 17% przypadków NAR⁴⁰. Wysokie rozpowszechnienie tego fenotypu budzi niepokój, ponieważ jest to potencjalnie możliwy do uniknięcia stan chorobowy⁴¹.

Nieżyt nosa wywołany lekami może być spowodowany przez leki bez recepty, takie jak kokaina⁴², ale również przez inne leki, takie jak doustne środki antykoncepcyjne, niektóre leki przeciwnadciśnieniowe czy niesteroidowe leki przeciwzapalne.

Niealergiczny nieżyt nosa z zespołem eozynofilii (NARES)

Niealergiczny nieżyt nosa z zespołem eozynofilii (Non-allergic rhinitis with eosinophilia syndrome, NARES) jest kolejnym ważnym fenotypem NAR. Obecność eozynofilów w błonie śluzowej nosa w NARES odróżnia go od innych podtypów NAR⁴³⁴⁴.

Częstość występowania NARES jest niższa niż innych fenotypów NAR⁴⁵. Badania Mullarkeya, Enberga i Settipane wskazują, że NARES stanowi większość pozostałych przypadków NAR po naczynioruchowym nieżycie nosa⁴⁶.

Miejscowy alergiczny nieżyt nosa (Local Allergic Rhinitis)

Stosunkowo nowym konceptem w klasyfikacji nieżytu nosa jest miejscowy alergiczny nieżyt nosa (Local allergic rhinitis, LAR). Jest to stan, w którym pacjenci mają objawy alergicznego nieżytu nosa, ale bez wykrywalnej ogólnoustrojowej alergii⁴⁷.

Niedawno wykazano, że LAR jest częstą chorobą układu oddechowego, z częstością występowania wynoszącą 25,7% populacji z nieżytem nosa w praktyce badaczy⁴⁸. Jednakże do diagnozy LAR potrzebny jest donosowy test prowokacji alergenem (NAPT), a dalsze badania są konieczne do zbadania rozpowszechnienia tego zjawiska w różnych obszarach geograficznych⁴⁹.

Trendy czasowe w epidemiologii niealergicznego nieżytu nosa

Analiza trendów czasowych w epidemiologii nieżytu nosa dostarcza cennych informacji na temat zmian w częstości występowania tej choroby na przestrzeni lat.

Wzrost częstości występowania nieżytu nosa

Większość badań donosi o wzroście częstości występowania nieżytu nosa (zarówno alergicznego, jak i niealergicznego) w ciągu ostatnich dekad⁵⁰. Na całym świecie częstość występowania alergicznego nieżytu nosa nieznacznie wzrosła, dotykając obecnie około 10-30% dorosłych i 40% dzieci⁵¹.

Jednakże, podczas gdy częstość występowania alergicznego nieżytu nosa wzrasta wraz z wiekiem, częstość występowania niealergicznego nieżytu nosa wykazuje tendencję spadkową⁵². Jest to szczególnie widoczne w populacji pediatrycznej, gdzie niealergiczny nieżyt nosa jest bardziej rozpowszechniony w pierwszych 2 latach życia, ale jego częstość maleje wraz z wiekiem, podczas gdy częstość alergicznego nieżytu nosa wzrasta⁵³.

Zróżnicowanie geograficzne

Istnieje znaczna zmienność geograficzna w częstości występowania nieżytu nosa⁵⁴⁵⁵. Badanie European Community Respiratory Health wykazało częstość występowania alergicznego nieżytu nosa u dorosłych na poziomie 10-41%⁵⁶. Badania skandynawskie wykazały skumulowaną częstość występowania na poziomie 15% u mężczyzn i 14% u kobiet⁵⁷.

Najwyższą częstość występowania ciężkich objawów alergicznego nieżytu nosa u dzieci obserwowano w Afryce i Ameryce Łacińskiej⁵⁸. Sugeruje się również, że ostatni wzrost częstości występowania niealergicznego nieżytu nosa w szybko rozwijających się regionach, takich jak niektóre kraje azjatyckie, może być związany z zanieczyszczeniem środowiska⁵⁹.

Choroby współistniejące i czynniki ryzyka

Niealergiczny nieżyt nosa często współistnieje z innymi chorobami, co może wpływać na jego przebieg kliniczny i leczenie.

Astma

Niealergiczny nieżyt nosa często współistnieje z astmą i może być związany z zaostrzeniami astmy⁶⁰. Niedawne dowody pokazują, że astma i nieżyt nosa często współistnieją zarówno u pacjentów atopowych, jak i nieatopowych, a skuteczne leczenie nieżytu nosa często poprawia przebieg astmy⁶¹.

Ta korelacja podkreśla znaczenie odpowiedniej diagnozy i leczenia NAR u pacjentów z astmą.

Inne choroby współistniejące

Alergiczny nieżyt nosa jest również związany z zapaleniem ucha środkowego, dysfunkcją trąbki słuchowej, zapaleniem zatok, polipami nosa, alergicznym zapaleniem spojówek i atopowym zapaleniem skóry⁶². Wiele z tych chorób współistniejących może również występować u pacjentów z NAR.

W badaniu przeprowadzonym w Chinach stwierdzono, że wywiad rodzinny AR oraz współistniejąca astma, przewlekłe zapalenie zatok przynosowych (CRS) lub atopowe zapalenie skóry były związane ze zwiększonym ryzykiem zarówno AR, jak i NAR⁶³.

Choroba refluksowa

Niedawne badania wykazały również związek między NAR a chorobą refluksową. Badanie pilotażowe wykazało wysoki poziom pepsyny w próbkach śliny pacjentów z NAR w porównaniu z zdrową populacją kontrolną, co sugeruje wyraźny związek między chorobą refluksową a NAR⁶⁴.

Te wyniki sugerują, że lekarze leczący pacjentów z NAR powinni rozważyć leczenie refluksu u pacjentów z wysokimi stężeniami pepsyny⁶⁵.

Obciążenie ekonomiczne i wpływ na jakość życia

Niealergiczny nieżyt nosa, podobnie jak inne formy przewlekłego nieżytu nosa, może mieć znaczący wpływ na jakość życia pacjentów i generować znaczne koszty ekonomiczne.

Wpływ na jakość życia

Przewlekły nieżyt nosa (zarówno alergiczny, jak i niealergiczny) może znacząco wpływać na jakość życia pacjentów. Badania wykazały, że objawy nosowe często zakłócają codzienne czynności i zaburzają wzorzec snu, prowadząc do negatywnych konsekwencji dla życia społecznego i osiągnięć intelektualnych⁶⁶.

Alergiczny nieżyt nosa często prowadzi do znacznego upośledzenia jakości życia⁶⁷, a podobne efekty można zaobserwować u pacjentów z NAR. Niezależnie od typu, nieleczone lub niekontrolowane objawy nieżytu nosa mogą znacząco wpływać na jakość życia⁶⁸.

Koszty ekonomiczne

Koszty ekonomiczne związane z NAR są prawdopodobnie znacznie niedoszacowane ze względu na wiele podtypów choroby⁶⁹. Obejmują one zarówno koszty bezpośrednie (leki, wizyty lekarskie, hospitalizacje), jak i pośrednie (utrata produktywności, absencja w pracy i szkole).

Wszystkie te aspekty sprawiają, że przewlekły nieżyt nosa jest globalnym problemem zdrowotnym charakteryzującym się znacznymi kosztami bezpośrednimi i pośrednimi dla społeczeństwa⁷⁰.

Monitoring i diagnostyka niealergicznego nieżytu nosa

Monitoring i diagnostyka NAR stanowią istotne wyzwanie ze względu na brak standardowej definicji i kryteriów diagnostycznych.

Wyzwania diagnostyczne

Diagnoza niealergicznego nieżytu nosa jest diagnozą z wykluczenia, stawianą po wyeliminowaniu przyczyn alergicznych lub mediowanych przez IgE⁷¹. Wymaga to negatywnych odpowiedzi IgE-specyficznych w testach skórnych lub serologicznych⁷²⁷³.

W pediatrii, diagnostyczna definicja niealergicznego nieżytu nosa często ograniczała się do wykluczenia uczulenia alergicznego⁷⁴. W rzeczywistości, miejscowy alergiczny nieżyt nosa był często błędnie diagnozowany, a mieszany nieżyt nosa nie był rozpoznawany w większości przypadków⁷⁵.

Ulepszone metody diagnostyczne

Cytologia nosowa jest procedurą diagnostyczną odpowiednią dla rutynowej praktyki klinicznej u dzieci i może być bardzo użytecznym narzędziem do charakteryzacji i diagnozy niealergicznego nieżytu nosa, dostarczając ważnych wskazówek dla analizy epidemiologicznej i postępowania klinicznego⁷⁶.

Połączenie standardowych kwestionariuszy i testów na konkretne alergeny może zapewnić dokładniejsze szacunki częstości występowania AR i NAR oraz związanych z nimi czynników ryzyka⁷⁷.

Luki w monitorowaniu

Istnieje wiele luk w literaturze dotyczących patogenezy, diagnozy klinicznej i laboratoryjnej NAR, a także istnieje duża luka w wiedzy na temat wyników medycznych i chirurgicznych⁷⁸.

Badanie wiedzy, które obejmowało ocenę i przegląd 115 tytułów z Medline, w tym 4 przeglądy systematyczne i 34 prace badawcze, a także 2 najnowsze podręczniki otolaryngologii, ujawniło, że nie ma badań na temat częstości występowania NAR z Omanu. Chociaż najnowsze teksty jasno definiują NAR, w literaturze jest niewiele informacji na temat częstości występowania, diagnozy i wyników leczenia NAR⁷⁹.

Przyszłe kierunki badań nad epidemiologią niealergicznego nieżytu nosa

Mimo postępów w zrozumieniu epidemiologii NAR, nadal istnieje wiele obszarów wymagających dalszych badań.

Potrzeba standaryzowanej definicji

Jednym z głównych wyzwań w badaniach nad NAR jest brak standaryzowanej definicji i kryteriów diagnostycznych⁸⁰. Określenie takiej definicji mogłoby ułatwić porównywanie badań epidemiologicznych i poprawić zrozumienie prawdziwego rozpowszechnienia NAR.

Badania nad fenotypami

Potrzebne są dalsze badania nad różnymi fenotypami NAR, ich względną częstością występowania i specyficznymi cechami klinicznymi. Badania te mogą pomóc w opracowaniu bardziej ukierunkowanych strategii leczenia dla różnych podtypów NAR⁸¹.

Zapobieganie fenotypom możliwym do uniknięcia

Szczególną uwagę należy zwrócić na fenotypy NAR, które są potencjalnie możliwe do uniknięcia, takie jak nieżyt nosa wywołany lekami (rhinitis medicamentosa). Wysoka częstość występowania tego fenotypu budzi niepokój i wymaga uwagi w codziennej praktyce klinicznej⁸².

Zrozumienie czynników ryzyka i opracowanie strategii zapobiegania tym fenotypom może pomóc w zmniejszeniu ogólnego obciążenia NAR.

Badania pediatryczne

Istnieje potrzeba lepszego zrozumienia epidemiologii NAR w populacji pediatrycznej. Dokładna częstość występowania NAR u dzieci nie jest znana⁸³, a dalsze badania w tym obszarze mogą pomóc w opracowaniu bardziej skutecznych strategii diagnostycznych i terapeutycznych dla dzieci z NAR.

W szczególności, zrozumienie przejścia od NAR do AR wraz z wiekiem może dostarczyć cennych informacji na temat naturalnej historii nieżytu nosa u dzieci⁸⁴.

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Nonallergic Rhinitis | IntechOpen
https://www.intechopen.com/chapters/1180286
Non-allergic rhinitis (NAR) is a heterogeneous nasal disease with high global prevalence. […] Limited data are available regarding the prevalence of general rhinitis, with even fewer statistics on Nonallergic rhinitis. However, estimates indicate that over 70 million individuals in the United States and 200 million globally are affected by chronic rhinitis. […] The absence of prevalence data for nonallergic rhinitis is attributed to the lack of a standardized definition and diagnostic criteria, as highlighted by Hellings. […] Savoure et al. perform a study of worldwide prevalence of rhinitis and described unspecified rhinitis prevalence at 29.4% (1.1 to 63.3%), allergic rhinitis with 18.1% (1 to 54.5%) and 12% for nonallergic rhinitis (4 to 31.4%). […] Dykewicz et al. estimated nonallergic rhinitis affect 1752% of adults in the United States and 34% may have a mixed rhinitis. […] An important difference between nonallergic and allergic rhinitis is the seasonality of symptoms. Savoure et al. referred allergic rhinitis increased from March to June (spring) and nonallergic rhinitis increased during winter and decreases from May to September.
#2 Nonallergic Rhinitis | Ento Key
https://entokey.com/nonallergic-rhinitis/
The prevalence of mixed rhinitis is likely underappreciated. […] There are also multiple biases in reporting. […] Most prevalence data are collected from physician reporting and retrospective data from the clinical offices of allergists and otorhinolaryngologists where specialty referral patterns may not represent the true prevalence of the general population.
#3 Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management
https://www.wjgnet.com/2222-0682/full/v6/i4/200.htm
Chronic rhinitis is a very common disease, as the prevalence in the general population resulted to be 40%. […] Non-allergic rhinitis has been estimated to account for 25%. […] In pediatrics, the diagnostic definition of non-allergic rhinitis has been often limited to the exclusion of an allergic sensitization. […] Actually, local allergic rhinitis has been often misdiagnosed as well as mixed rhinitis has not been recognized in most cases. […] Nasal cytology is a diagnostic procedure being suitable for routine clinical practice with children and could be a very useful tool to characterize and diagnose non-allergic rhinitis, providing important clues for epidemiological analysis and clinical management. […] Chronic rhinitis (CR) is a very common disease with an increasing incidence, especially in the Western countries, where the actual prevalence in the general population is between 10% and 40%, according to different studies.
#4 The prevalence of nonâallergic rhinitis phenotypes in the general population: A crossâsectional study
https://pmc.ncbi.nlm.nih.gov/articles/PMC9306544/
The prevalence of nonallergic rhinitis (NAR) phenotypes in the general population is currently unknown. […] The prevalence of chronic rhinitis in the general population was 40% (N = 558, of those, 65% had NAR and 28% AR, in 7% allergy status is unknown). […] This is the first study to describe the prevalences of NAR phenotypes in the general population. […] Our data on the prevalence of phenotypes may help clinicians to anticipate the type of patients at their clinic and help guide a tailored treatment approach. […] The high prevalence of rhinitis medicamentosa is alarming, since this is a potentially preventable phenotype. […] We found a prevalence of NAR of 28% in the general population. […] The aim of this study was to determine the prevalence of NAR phenotypes in the general population.
#5 The prevalence of nonâallergic rhinitis phenotypes in the general population: A crossâsectional study
https://pmc.ncbi.nlm.nih.gov/articles/PMC9306544/
The prevalence of nonallergic rhinitis (NAR) phenotypes in the general population is currently unknown. […] The prevalence of chronic rhinitis in the general population was 40% (N = 558, of those, 65% had NAR and 28% AR, in 7% allergy status is unknown). […] This is the first study to describe the prevalences of NAR phenotypes in the general population. […] Our data on the prevalence of phenotypes may help clinicians to anticipate the type of patients at their clinic and help guide a tailored treatment approach. […] The high prevalence of rhinitis medicamentosa is alarming, since this is a potentially preventable phenotype. […] We found a prevalence of NAR of 28% in the general population. […] The aim of this study was to determine the prevalence of NAR phenotypes in the general population.
#6 Epidemiology of Vasomotor Rhinitis | World Allergy Organization Journal | Full Text
https://waojournal.biomedcentral.com/articles/10.1097/WOX.0b013e3181ac91ae
Applying the 3:1 (AR/NAR) ratio, approximately 20 million Americans would be expected to suffer from NAR (or approximately 7% of the total population). […] The studies by Mullarkey, Enberg, and Settipane unanimously support VMR as the most common NAR subtype, making up approximately 71% of NAR diagnoses, with NARES making up the majority of the remaining NAR conditions. […] Applying the same frequency to the 450 million worldwide population suffering from NAR yields an estimate of a worldwide prevalence of VMR of 320 million. […] it is clear that VMR is, by far, the most common subtype of NAR with a significant burden of illness in the United States and worldwide.
#7 Non Allergic Rhinitis: Prevalence, Clinical Profile and Knowledge Gaps in Literature
https://pmc.ncbi.nlm.nih.gov/articles/PMC3251201/
Although Nasal symptoms induced by Non-allergic rhinitis| (NAR) are a cause of wide spread morbidity; the disease is trivialized. There is a lack of Epidemiological studies on the prevalence of non-allergic rhinitis. […] The overall prevalence of rhinitis was 18.5% (n=113). The prevalence of NAR was 7.5% (n=46). […] The knowledge gap study which consisted of the assessment and review of 115 Medline titles including 4 systematic reviews, and 34 research papers, as well as 2 recent otolaryngology text books revealed that no study on the prevalence of NAR from Oman. Although the recent text now clearly defines NAR, there is scant literature on the prevalence, diagnosis and management outcomes of NAR in the literature. […] The prevalence of pure chronic NAR represents 17-52% amongst the rhinitis population.
#8 Non Allergic Rhinitis: Prevalence, Clinical Profile and Knowledge Gaps in Literature
https://pmc.ncbi.nlm.nih.gov/articles/PMC3251201/
Prevalence of NAR in Oman was found to be 57% of the rhinitis population, these figures are very similar to the ones mentioned in literature. […] Many knowledge gaps exist in the literature with relations to pathogenesis, clinical and laboratory diagnosis and there is a large knowledge gap with reference to medical as well as surgical outcomes.
#9 Prevalence of allergic and nonallergic rhinitis in a rural area of northern China based on sensitization to specific aeroallergens | Allergy, Asthma & Clinical Immunology | Full Text
https://aacijournal.biomedcentral.com/articles/10.1186/s13223-018-0299-9
Most epidemiologic studies reporting prevalence of allergic rhinitis (AR) and nonallergic rhinitis (NAR) have assessed solely self-reported prevalence, without confirmation by objective measures. […] Thus, we aimed to explore the prevalence and risk factors of AR and NAR in a Chinese, based on both clinical manifestation and allergic status. […] The confirmed standardized prevalence of AR and NAR were 16.78% and 24.60%, respectively. […] Combination of standardized questionnaires and specific allergen tests may provide more accurate estimates of prevalence of AR and NAR and associated risk factors. […] Few epidemiologic studies have been reported on NAR, and most of the studies have concentrated solely on the self-reported prevalence. […] The aim of the present study was therefore to assess the prevalence of clinical AR and NAR, using both subjective and objective tests, and the associated risk factors in Chinese subjects from a rural community in Beijing, China.
#10 AAIR :: Allergy, Asthma & Immunology Research
https://e-aair.org/DOIx.php?id=10.4168/aair.2011.3.3.148
Nonallergic rhinitis (NAR) is generally described as chronic nasal symptoms, such as obstruction and rhinorrhea that occur in relation to nonallergic, noninfectious triggers such as change in the weather, exposure to caustic odors or cigarette smoke, barometric pressure differences, etc. […] The exact prevalence and impact of NAR is not as established as it is for allergic rhinitis. It is estimated that it affects more than 19 to 20 million patients in the United States, with vasomotor rhinitis being the most common subtype seen. […] With many subtypes of disease, the true economic burden of NAR is most likely grossly underestimated. […] As Ledford points out in his symposium on assessing the damage of inadequately diagnosed NAR, patients are often empirically treated with oral second generation antihistamines, which are usually not sufficient in relieving their symptoms.
#11 Management of Rhinitis: Allergic and Non-Allergic
https://e-aair.org/search.php?where=aview&id=10.4168/aair.2011.3.3.148&code=9999AAIR&vmode=PUBREADER
Nonallergic rhinitis (NAR) is generally described as chronic nasal symptoms, such as obstruction and rhinorrhea that occur in relation to nonallergic, noninfectious triggers such as change in the weather, exposure to caustic odors or cigarette smoke, barometric pressure differences, etc. […] The exact prevalence and impact of NAR is not as established as it is for allergic rhinitis. It is estimated that it affects more than 19 to 20 million patients in the United States, with vasomotor rhinitis being the most common subtype seen. […] With many subtypes of disease, the true economic burden of NAR is most likely grossly underestimated. […] As Ledford points out in his symposium on assessing the damage of inadequately diagnosed NAR, patients are often empirically treated with oral second generation antihistamines, which are usually not sufficient in relieving their symptoms.
#12 Nonallergic Rhinitis: Definition, Classification, and Management | Ento Key
https://entokey.com/nonallergic-rhinitis-definition-classification-and-management/
Chronic rhinitis can be classified roughly as allergic, infectious, or nonallergic, noninfectious. It is estimated that 50% of cases of chronic rhinitis is nonallergic. […] Nonallergic rhinitis is common and is estimated to affect more than 200 million people worldwide. However, its exact prevalence is unknown, and its phenotypes need to be evaluated using appropriate methods for diagnosis and management. […] The prevalence of allergic and nonallergic rhinitis is reported to be between 10 and 50% of the population. Of these patients, about one-quarter to one-half of cases is reported to be nonallergic. […] Nonallergic rhinitis tends to be adult onset, with the typical age of presentation between 30 and 60 years. […] In adults, most studies report a clear female predominance, with estimates ranging from 58 to 71% of those affected being female. […] Nonallergic rhinitis is uncommon in children; allergic rhinitis or anatomical factors are much more often the source of rhinitic symptoms.
#13 Epidemiology of Vasomotor Rhinitis | World Allergy Organization Journal | Full Text
https://waojournal.biomedcentral.com/articles/10.1097/WOX.0b013e3181ac91ae
Vasomotor rhinitis is the most common form of nonallergic rhinitis, comprising approximately 71% of all nonallergic rhinitis conditions. […] it is estimated that 14 million Americans suffer from vasomotor rhinitis, with a worldwide prevalence approaching 320 million. […] Determination of the epidemiology of VMR is confounded by numerous challenges as shown in Table 1. […] To date, no prospective epidemiologic studies have applied such a protocol to evaluate a large population of rhinitis patients. Consequently, current estimates regarding the prevalence of VMR are fairly crude. […] The data from rhinitis epidemiology studies suggest that the ratio of AR prevalence (pure and mixed combined) to that of pure NAR is 3:1. […] If the assumption is made that 20% of the population suffers from AR, then on the basis of current population estimates for the United States of just more than 300 million, the US prevalence of AR is 60 million people.
#14 Epidemiology of vasomotor rhinitis – Document – Gale Academic OneFile
https://go.gale.com/ps/i.do?id=GALE%7CA323117825&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=19394551&p=AONE&sw=w
Vasomotor rhinitis is the most common form of nonallergic rhinitis, comprising approximately 71% of all nonallergic rhinitis conditions. […] Although the epidemiology of this subtype of nonallergic rhinitis has not been definitively studied, it is estimated that 14 million Americans suffer from vasomotor rhinitis, with a worldwide prevalence approaching 320 million.
#15 Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management
https://www.wjgnet.com/2222-0682/full/v6/i4/200.htm
Prevalence studies on adults estimated that NAR could affect almost 20 million people in the United States, 50 million people in Europe and more than 200 million people worldwide. […] However, because of its poor clinical and pathological definition, NAR is often under-considered by clinicians and, as a consequence, the epidemiological burden is also under-estimated, especially in the pediatric age. […] Actually, the exact prevalence of NAR in children is not known, but the comparative prevalence between NAR and AR was estimated to be to be at least 1:3-4. […] A recent retrospective analysis by Topal et al regarding 472 consecutive children evaluated for CR within 1-year period, showed that 76.9% patients were diagnosed with AR and, thus, the remaining 23.1% children had NAR. […] Previously, another pediatric study by Chiang et al enrolling 660 children (aged 1 to 18 year) with CR, provided very similar results, as AR was diagnosed in 75.9% cases and, by exclusion, NAR represented 24.1% of the total.
#16 Nonallergic Rhinitis: Definition, Classification, and Management | Ento Key
https://entokey.com/nonallergic-rhinitis-definition-classification-and-management/
Chronic rhinitis can be classified roughly as allergic, infectious, or nonallergic, noninfectious. It is estimated that 50% of cases of chronic rhinitis is nonallergic. […] Nonallergic rhinitis is common and is estimated to affect more than 200 million people worldwide. However, its exact prevalence is unknown, and its phenotypes need to be evaluated using appropriate methods for diagnosis and management. […] The prevalence of allergic and nonallergic rhinitis is reported to be between 10 and 50% of the population. Of these patients, about one-quarter to one-half of cases is reported to be nonallergic. […] Nonallergic rhinitis tends to be adult onset, with the typical age of presentation between 30 and 60 years. […] In adults, most studies report a clear female predominance, with estimates ranging from 58 to 71% of those affected being female. […] Nonallergic rhinitis is uncommon in children; allergic rhinitis or anatomical factors are much more often the source of rhinitic symptoms.
#17 Allergic Rhinitis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/134825-overview
The prevalence of allergic rhinitis in the United States is estimated to be 7.7% affecting roughly 19.2 million adults each year. In 2018, 7.2% of children younger than 18 years reported symptoms of allergic rhinitis in the past 12 months. […] The development of allergic rhinitis before 20 years of age occurs in 80% of cases. […] Throughout the world, the prevalence of allergic rhinitis has slightly escalated. […] Currently, approximately 10 to 30% of adults and 40% of children are affected. […] The European Community Resporatory Health survey recorded a prevalence of 10 to 41% in adults with allergic rhinitis. […] Scandinavian studies have demonstrated a cumulative prevalence rate of 15% in men and 14% in women. […] The prevalence of allergic rhinitis may vary within and among countries.
#18 Rhinitis, Cold Air-Induced | 5-Minute Clinical Consult
https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816428/all/Rhinitis__Cold_Air_Induced
Overall epidemiology of rhinitis conditions is difficult to assess due to challenges in classifying rhinitis. […] Prevalence of cold air sensitivity in nonallergic chronic rhinitis is not known. […] Rhinitis is a very common disorder affecting 20-40% of the Western population. […] Most ENT clinics report a 50-50 division between allergic and nonallergic patients. […] Nonallergic rhinitis presents later in life than allergic rhinitis, with 70% of patients presenting after 20 years of age. […] The prevalence of nonallergic rhinitis in children is not well studied.
#19 Nonallergic Rhinitis: Definition, Classification, and Management | Ento Key
https://entokey.com/nonallergic-rhinitis-definition-classification-and-management/
Chronic rhinitis can be classified roughly as allergic, infectious, or nonallergic, noninfectious. It is estimated that 50% of cases of chronic rhinitis is nonallergic. […] Nonallergic rhinitis is common and is estimated to affect more than 200 million people worldwide. However, its exact prevalence is unknown, and its phenotypes need to be evaluated using appropriate methods for diagnosis and management. […] The prevalence of allergic and nonallergic rhinitis is reported to be between 10 and 50% of the population. Of these patients, about one-quarter to one-half of cases is reported to be nonallergic. […] Nonallergic rhinitis tends to be adult onset, with the typical age of presentation between 30 and 60 years. […] In adults, most studies report a clear female predominance, with estimates ranging from 58 to 71% of those affected being female. […] Nonallergic rhinitis is uncommon in children; allergic rhinitis or anatomical factors are much more often the source of rhinitic symptoms.
#20 Vasomotor Rhinitis: Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/17950-nonallergic-rhinitis
Vasomotor (nonallergic) rhinitis is inflammation of nasal tissues that results in sneezing, nasal congestion, runny nose or postnasal drip. […] Unlike allergic rhinitis (or hay fever), the symptoms are of an unknown cause. […] Vasomotor is also called idiopathic rhinitis. Its a type of nonallergic rhinitis. […] Anyone can develop vasomotor rhinitis, but most people get diagnosed after age 20. The majority of diagnoses occur between ages 30 and 60. Its more common in women. […] Allergic and nonallergic rhinitis (including vasomotor rhinitis) affects up to half of the population in industrialized countries. Vasomotor rhinitis accounts for anywhere from 15% to half of these cases. […] Nonallergic rhinitis may also result from using nonprescription drugs, like cocaine. […] A healthcare provider can diagnose vasomotor rhinitis with a physical exam of your nose and throat and a review of your medical history.
#21 Nonallergic Rhinitis: Definition, Classification, and Management | Ento Key
https://entokey.com/nonallergic-rhinitis-definition-classification-and-management/
Chronic rhinitis can be classified roughly as allergic, infectious, or nonallergic, noninfectious. It is estimated that 50% of cases of chronic rhinitis is nonallergic. […] Nonallergic rhinitis is common and is estimated to affect more than 200 million people worldwide. However, its exact prevalence is unknown, and its phenotypes need to be evaluated using appropriate methods for diagnosis and management. […] The prevalence of allergic and nonallergic rhinitis is reported to be between 10 and 50% of the population. Of these patients, about one-quarter to one-half of cases is reported to be nonallergic. […] Nonallergic rhinitis tends to be adult onset, with the typical age of presentation between 30 and 60 years. […] In adults, most studies report a clear female predominance, with estimates ranging from 58 to 71% of those affected being female. […] Nonallergic rhinitis is uncommon in children; allergic rhinitis or anatomical factors are much more often the source of rhinitic symptoms.
#22 Chronic Nonallergic Rhinitis
https://fpnotebook.com/ENT/Nose/ChrncNnlrgcRhnts.htm
Prevalence: 20-30 Million in U.S. […] Accounts for 23% of Rhinitis cases in U.S. […] More common in women (by factor of 2:1 to 3:1) […] Age 35 years old (contrast with Allergic Rhinitis onset 20 years old) […] Typically no Family History of Allergic Rhinitis, Asthma or Eczema […] Perennial onset (but may also be seasonal)
#23 Rhinitis, Cold Air-Induced | 5-Minute Clinical Consult
https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816428/all/Rhinitis__Cold_Air_Induced
Overall epidemiology of rhinitis conditions is difficult to assess due to challenges in classifying rhinitis. […] Prevalence of cold air sensitivity in nonallergic chronic rhinitis is not known. […] Rhinitis is a very common disorder affecting 20-40% of the Western population. […] Most ENT clinics report a 50-50 division between allergic and nonallergic patients. […] Nonallergic rhinitis presents later in life than allergic rhinitis, with 70% of patients presenting after 20 years of age. […] The prevalence of nonallergic rhinitis in children is not well studied.
#24 Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management
https://www.wjgnet.com/2222-0682/full/v6/i4/200.htm
Prevalence studies on adults estimated that NAR could affect almost 20 million people in the United States, 50 million people in Europe and more than 200 million people worldwide. […] However, because of its poor clinical and pathological definition, NAR is often under-considered by clinicians and, as a consequence, the epidemiological burden is also under-estimated, especially in the pediatric age. […] Actually, the exact prevalence of NAR in children is not known, but the comparative prevalence between NAR and AR was estimated to be to be at least 1:3-4. […] A recent retrospective analysis by Topal et al regarding 472 consecutive children evaluated for CR within 1-year period, showed that 76.9% patients were diagnosed with AR and, thus, the remaining 23.1% children had NAR. […] Previously, another pediatric study by Chiang et al enrolling 660 children (aged 1 to 18 year) with CR, provided very similar results, as AR was diagnosed in 75.9% cases and, by exclusion, NAR represented 24.1% of the total.
#25 Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis
https://www.e-cep.org/journal/view.php?number=20125555352
Rhinitis is among the most common respiratory diseases in children. Nonallergic rhinitis accounts for 16%89% of the chronic rhinitis cases, affecting 1%50% (median 10%) of the total pediatric population. Nonallergic rhinitis is more prevalent during the first 2 years of life; however, its underestimation for children with atopic tendencies is likely due to low positive rates of specific allergic tests during early childhood. Studies have reported that the prevalence of nonallergic rhinitis is 0.7%50.0 % (median, 10.1%) in pediatric population. Nonallergic rhinitis seems to account for 15.7%89.0% of the chronic rhinitis cases. In epidemiologic studies, decreasing trends in the incidence of nonallergic rhinitis were observed, while the incidence of allergic rhinitis increased with age. Considering the data of the studies mentioned above, nonallergic rhinitis is found to be prevalent in children younger than 2 years with chronic rhinitis, and the proportion tends to decrease with age, whereas the proportion of allergic rhinitis increases.
#26 Clinical and Experimental Pediatrics
https://www.e-cep.org/m/journal/view.php?number=20125555352
Rhinitis is among the most common respiratory diseases in children. Nonallergic rhinitis accounts for 16%89% of the chronic rhinitis cases, affecting 1%50% (median 10%) of the total pediatric population. […] Nonallergic rhinitis is a diagnosis of exclusion that is characterized by signs and/or symptoms similar to allergic rhinitis (e.g., rhinorrhea, nasal obstruction, nasal itching, and sneezing after allergen exposure). Studies have reported that the prevalence of nonallergic rhinitis is 0.7%50.0 % (median, 10.1%) in pediatric population. Nonallergic rhinitis seems to account for 15.7%89.0% of the chronic rhinitis cases. […] In a birth cohort from the United Kingdom, a decreasing trend in the proportion of children with symptomatic rhinitis was estimated at 79%, 45%, and 42.3%, respectively, at 2, 4, and 10 years of age.
#27 Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis
https://www.e-cep.org/journal/view.php?number=20125555352
Rhinitis is among the most common respiratory diseases in children. Nonallergic rhinitis accounts for 16%89% of the chronic rhinitis cases, affecting 1%50% (median 10%) of the total pediatric population. Nonallergic rhinitis is more prevalent during the first 2 years of life; however, its underestimation for children with atopic tendencies is likely due to low positive rates of specific allergic tests during early childhood. Studies have reported that the prevalence of nonallergic rhinitis is 0.7%50.0 % (median, 10.1%) in pediatric population. Nonallergic rhinitis seems to account for 15.7%89.0% of the chronic rhinitis cases. In epidemiologic studies, decreasing trends in the incidence of nonallergic rhinitis were observed, while the incidence of allergic rhinitis increased with age. Considering the data of the studies mentioned above, nonallergic rhinitis is found to be prevalent in children younger than 2 years with chronic rhinitis, and the proportion tends to decrease with age, whereas the proportion of allergic rhinitis increases.
#28 Clinical and Experimental Pediatrics
https://www.e-cep.org/m/journal/view.php?number=20125555352
Rhinitis is among the most common respiratory diseases in children. Nonallergic rhinitis accounts for 16%89% of the chronic rhinitis cases, affecting 1%50% (median 10%) of the total pediatric population. […] Nonallergic rhinitis is a diagnosis of exclusion that is characterized by signs and/or symptoms similar to allergic rhinitis (e.g., rhinorrhea, nasal obstruction, nasal itching, and sneezing after allergen exposure). Studies have reported that the prevalence of nonallergic rhinitis is 0.7%50.0 % (median, 10.1%) in pediatric population. Nonallergic rhinitis seems to account for 15.7%89.0% of the chronic rhinitis cases. […] In a birth cohort from the United Kingdom, a decreasing trend in the proportion of children with symptomatic rhinitis was estimated at 79%, 45%, and 42.3%, respectively, at 2, 4, and 10 years of age.
#29 Clinical and Experimental Pediatrics
https://www.e-cep.org/m/journal/view.php?number=20125555352
A recent study of a Korean population reported that the prevalence of allergic rhinitis increased from 22.1% to 28.3% from 7 to 12 years of age, while that of nonallergic rhinitis decreased from 21.3% to 13.3%. […] Considering the data of the studies mentioned above, nonallergic rhinitis is found to be prevalent in children younger than 2 years with chronic rhinitis, and the proportion tends to decrease with age, whereas the proportion of allergic rhinitis increases. […] The prevalence of nonallergic rhinitis with eosinophilia syndrome is even lower. […] A correlation between nonallergic rhinitis and pollution has been suggested owing to the recent increase in nonallergic rhinitis rates in highly developing regions such as some Asian countries, but many aspects remain unknown. […] Here we review the prevalence, diagnosis, comorbidities, and treatment recommendations for nonallergic rhinitis versus allergic rhinitis in children.
#30 Demographics and Epidemiology of Allergic and Nonallergic Rhiniti…: Ingenta Connect
https://www.ingentaconnect.com/contentone/ocean/aap/2001/00000022/00000004/art00001
Chronic rhinitis symptoms are among the most common problems presenting to physicians. […] Estimates of the prevalence of allergic rhinitis range from as low as 9% to as high as 42%. […] Although nonallergic rhinitis is a well-recognized diagnosis, its prevalence has not been studied definitively. […] Population survey results have estimated that 19 million Americans suffer from nonallergic rhinitis. […] Because 44% of patients with allergic rhinitis may have concomitant nonallergic rhinitis, it is estimated that an additional 26 million people have a nonallergic component to their rhinitis (mixed rhinitis). Therefore, a total estimated 45 million people have either pure nonallergic rhinitis or mixed rhinitis. […] Because nonallergic rhinitis is common, it is important to differentiate this condition from rhinitis of allergic etiology.
#31 Demographics and Epidemiology of Allergic and Nonallergic Rhiniti…: Ingenta Connect
https://www.ingentaconnect.com/contentone/ocean/aap/2001/00000022/00000004/art00001
Chronic rhinitis symptoms are among the most common problems presenting to physicians. […] Estimates of the prevalence of allergic rhinitis range from as low as 9% to as high as 42%. […] Although nonallergic rhinitis is a well-recognized diagnosis, its prevalence has not been studied definitively. […] Population survey results have estimated that 19 million Americans suffer from nonallergic rhinitis. […] Because 44% of patients with allergic rhinitis may have concomitant nonallergic rhinitis, it is estimated that an additional 26 million people have a nonallergic component to their rhinitis (mixed rhinitis). Therefore, a total estimated 45 million people have either pure nonallergic rhinitis or mixed rhinitis. […] Because nonallergic rhinitis is common, it is important to differentiate this condition from rhinitis of allergic etiology.
#32 Rhinitis epidemiology and demographics – wikidoc
https://www.wikidoc.org/index.php/Rhinitis_epidemiology_and_demographics
Rhinitis is a highly prevalent disease with significant financial impact on the society. Chronic rhinitis is one of the most common problems seen by physicians. Nonallergic rhinitis is also very common, and it has been estimated to affect about 19 million people in the U.S. […] There is sometimes an overlap between allergic and nonallergic rhinitis, referred to as „mixed rhinitis”, and this has been estimated to affect about 26 million individuals in the United States. […] The onset of nonallergic (non-infectious) rhinitis is often after the age of 20 years. […] Nonallergic (non-infectious) rhinitis is predominantly seen in females.
#33 Nonallergic rhinitis: Common problem, chronic symptoms | MDedge
https://ma1.mdedge.com/content/nonallergic-rhinitis-common-problem-chronic-symptoms
A 55-year-old woman has come to the clinic because of clear rhinorrhea and nasal congestion, which occur year-round but are worse in the winter. She reports that at times her nose runs continuously. Nasal symptoms have been present for 4 to 5 years but are worsening. The clear discharge is not associated with sneezing or itching. Though she lives with a cat, her symptoms are not exacerbated by close contact with it. […] While allergic rhinitis affects 30 and 60 million Americans annually, or between 10% to 30% of US adults, how many have nonallergic rhinitis has been difficult to determine. […] In a study in allergy clinics, 23% of patients with rhinitis had the nonallergic form, 43% had the allergic form, and 34% had both forms (mixed rhinitis). Other studies have suggested that up to 52% of patients presenting to allergy clinics with rhinitis have nonallergic rhinitis.
#34 Nonallergic rhinitis: What clinicians should know – Pulmonology Advisor
https://www.pulmonologyadvisor.com/slideshow/slides/nonallergic-rhinitis-what-clinicians-should-know/
NAR is a common and often overlooked disorder because of its many nonspecific symptoms, lack of diagnostic testing, and frequent coexistence with AR. Proper diagnosis of NAR requires a high level of suspicion. A careful review of the patients history is essential, and allergen testing should be conducted to rule out AR; however, positivity for AR does not exclude the presence of NAR. Once diagnosed, use of topical intranasal glucocorticoids and topical antihistamines has been shown to provide the greatest relief of symptoms across the NAR spectrum, but treatment should always be tailored to the patients specific symptoms. In many cases, multifaceted interventions that use pharmacologic and adjunct strategies, such as trigger avoidance, are necessary for optimal relief. […] The prevalence of NAR remains unclear, but it appears to be common, with some estimates suggesting 19 million persons in the United States are affected.2 However, this number likely underestimates its prevalence because NAR is difficult to diagnose in the setting of allergen-specific immunoglobulin E (IgE) positivity and the condition has been found to coexist with AR in a substantial number of patients.2,3 Based on such findings, it has been suggested that 50% to 80% of patients with rhinitis may have NAR, whether alone or, more commonly, as a mixed disease with some form of AR.2,4 To ensure a proper diagnosis, which is essential for optimal relief of symptoms and avoidance of unnecessary medications and treatments, clinicians must maintain a high degree of suspicion for NAR and should not rule out its presence based on an AR diagnosis alone.
#35 Epidemiology of Vasomotor Rhinitis | World Allergy Organization Journal | Full Text
https://waojournal.biomedcentral.com/articles/10.1097/WOX.0b013e3181ac91ae
Vasomotor rhinitis is the most common form of nonallergic rhinitis, comprising approximately 71% of all nonallergic rhinitis conditions. […] it is estimated that 14 million Americans suffer from vasomotor rhinitis, with a worldwide prevalence approaching 320 million. […] Determination of the epidemiology of VMR is confounded by numerous challenges as shown in Table 1. […] To date, no prospective epidemiologic studies have applied such a protocol to evaluate a large population of rhinitis patients. Consequently, current estimates regarding the prevalence of VMR are fairly crude. […] The data from rhinitis epidemiology studies suggest that the ratio of AR prevalence (pure and mixed combined) to that of pure NAR is 3:1. […] If the assumption is made that 20% of the population suffers from AR, then on the basis of current population estimates for the United States of just more than 300 million, the US prevalence of AR is 60 million people.
#36 Epidemiology of vasomotor rhinitis – Document – Gale Academic OneFile
https://go.gale.com/ps/i.do?id=GALE%7CA323117825&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=19394551&p=AONE&sw=w
Vasomotor rhinitis is the most common form of nonallergic rhinitis, comprising approximately 71% of all nonallergic rhinitis conditions. […] Although the epidemiology of this subtype of nonallergic rhinitis has not been definitively studied, it is estimated that 14 million Americans suffer from vasomotor rhinitis, with a worldwide prevalence approaching 320 million.
#37 Rhinitis – Wikipedia
https://en.wikipedia.org/wiki/Rhinitis
Nonallergic rhinitis refers to rhinitis that is not due to an allergy. […] The diagnosis is made upon excluding allergic causes. […] Non-allergic rhinitis can co-exist with allergic rhinitis, and is referred to as „mixed rhinitis”. […] An estimated 17 million United States citizens have vasomotor rhinitis. […] The role of transient receptor potential ion channels on the non-neuronal nasal epithelial cells has also been suggested. […] A systematic review on non-allergic rhinitis reports improvement of overall function after treatment with capsaicin (the active component of chili peppers).
#38 Vasomotor Rhinitis: Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/17950-nonallergic-rhinitis
Vasomotor (nonallergic) rhinitis is inflammation of nasal tissues that results in sneezing, nasal congestion, runny nose or postnasal drip. […] Unlike allergic rhinitis (or hay fever), the symptoms are of an unknown cause. […] Vasomotor is also called idiopathic rhinitis. Its a type of nonallergic rhinitis. […] Anyone can develop vasomotor rhinitis, but most people get diagnosed after age 20. The majority of diagnoses occur between ages 30 and 60. Its more common in women. […] Allergic and nonallergic rhinitis (including vasomotor rhinitis) affects up to half of the population in industrialized countries. Vasomotor rhinitis accounts for anywhere from 15% to half of these cases. […] Nonallergic rhinitis may also result from using nonprescription drugs, like cocaine. […] A healthcare provider can diagnose vasomotor rhinitis with a physical exam of your nose and throat and a review of your medical history.
#39 Epidemiology of Vasomotor Rhinitis | World Allergy Organization Journal | Full Text
https://waojournal.biomedcentral.com/articles/10.1097/WOX.0b013e3181ac91ae
Applying the 3:1 (AR/NAR) ratio, approximately 20 million Americans would be expected to suffer from NAR (or approximately 7% of the total population). […] The studies by Mullarkey, Enberg, and Settipane unanimously support VMR as the most common NAR subtype, making up approximately 71% of NAR diagnoses, with NARES making up the majority of the remaining NAR conditions. […] Applying the same frequency to the 450 million worldwide population suffering from NAR yields an estimate of a worldwide prevalence of VMR of 320 million. […] it is clear that VMR is, by far, the most common subtype of NAR with a significant burden of illness in the United States and worldwide.
#40 The prevalence of nonâallergic rhinitis phenotypes in the general population: A crossâsectional study
https://pmc.ncbi.nlm.nih.gov/articles/PMC9306544/
This is the first paper that describes the prevalence of NAR phenotypes in the general population. […] The second most common phenotype was RM (17% of NAR). […] A high prevalence of RM is a major concern, seeing that this is a preventable phenotype, and warrants attention in our daily practice because it is something often not spontaneously mentioned by our patients.
#41 The prevalence of nonâallergic rhinitis phenotypes in the general population: A crossâsectional study
https://pmc.ncbi.nlm.nih.gov/articles/PMC9306544/
The prevalence of nonallergic rhinitis (NAR) phenotypes in the general population is currently unknown. […] The prevalence of chronic rhinitis in the general population was 40% (N = 558, of those, 65% had NAR and 28% AR, in 7% allergy status is unknown). […] This is the first study to describe the prevalences of NAR phenotypes in the general population. […] Our data on the prevalence of phenotypes may help clinicians to anticipate the type of patients at their clinic and help guide a tailored treatment approach. […] The high prevalence of rhinitis medicamentosa is alarming, since this is a potentially preventable phenotype. […] We found a prevalence of NAR of 28% in the general population. […] The aim of this study was to determine the prevalence of NAR phenotypes in the general population.
#42 Vasomotor Rhinitis: Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/17950-nonallergic-rhinitis
Vasomotor (nonallergic) rhinitis is inflammation of nasal tissues that results in sneezing, nasal congestion, runny nose or postnasal drip. […] Unlike allergic rhinitis (or hay fever), the symptoms are of an unknown cause. […] Vasomotor is also called idiopathic rhinitis. Its a type of nonallergic rhinitis. […] Anyone can develop vasomotor rhinitis, but most people get diagnosed after age 20. The majority of diagnoses occur between ages 30 and 60. Its more common in women. […] Allergic and nonallergic rhinitis (including vasomotor rhinitis) affects up to half of the population in industrialized countries. Vasomotor rhinitis accounts for anywhere from 15% to half of these cases. […] Nonallergic rhinitis may also result from using nonprescription drugs, like cocaine. […] A healthcare provider can diagnose vasomotor rhinitis with a physical exam of your nose and throat and a review of your medical history.
#43 Non-allergic rhinitis – Symptoms, diagnosis and treatment | BMJ Best Practice US
https://bestpractice.bmj.com/topics/en-us/231
For non-allergic rhinitis, traditional triggers such as cat or dog exposure should be absent. […] A diagnosis of NAR requires negative specific IgE responses by skin or serologic testing. […] Environmental tobacco smoke, perfumes and fragrances, as well as temperature and barometric changes may aggravate symptoms in NAR, but specific IgE responses by skin or serologic testing are all negative. […] The presence of eosinophils in the nasal mucosa in NARES distinguishes it from other subtypes of NAR. […] To establish a definitive diagnosis of NAR, all other chronic rhinitis syndromes should be properly considered and excluded.
#44 Non-allergic rhinitis – Symptoms, diagnosis and treatment | BMJ Best Practice
https://bestpractice.bmj.com/topics/en-gb/231
For non-allergic rhinitis, traditional triggers such as cat or dog exposure should be absent. […] A diagnosis of NAR requires negative specific IgE responses by skin or serological testing. […] Environmental tobacco smoke, perfumes and fragrances, as well as temperature and barometric changes may aggravate symptoms in NAR, but specific IgE responses by skin or serological testing are all negative. […] The presence of eosinophils in the nasal mucosa in NARES distinguishes it from other sub-types of NAR. […] To establish a definitive diagnosis of NAR, all other chronic rhinitis syndromes should be properly considered and excluded.
#45 Clinical and Experimental Pediatrics
https://www.e-cep.org/m/journal/view.php?number=20125555352
A recent study of a Korean population reported that the prevalence of allergic rhinitis increased from 22.1% to 28.3% from 7 to 12 years of age, while that of nonallergic rhinitis decreased from 21.3% to 13.3%. […] Considering the data of the studies mentioned above, nonallergic rhinitis is found to be prevalent in children younger than 2 years with chronic rhinitis, and the proportion tends to decrease with age, whereas the proportion of allergic rhinitis increases. […] The prevalence of nonallergic rhinitis with eosinophilia syndrome is even lower. […] A correlation between nonallergic rhinitis and pollution has been suggested owing to the recent increase in nonallergic rhinitis rates in highly developing regions such as some Asian countries, but many aspects remain unknown. […] Here we review the prevalence, diagnosis, comorbidities, and treatment recommendations for nonallergic rhinitis versus allergic rhinitis in children.
#46 Epidemiology of Vasomotor Rhinitis | World Allergy Organization Journal | Full Text
https://waojournal.biomedcentral.com/articles/10.1097/WOX.0b013e3181ac91ae
Applying the 3:1 (AR/NAR) ratio, approximately 20 million Americans would be expected to suffer from NAR (or approximately 7% of the total population). […] The studies by Mullarkey, Enberg, and Settipane unanimously support VMR as the most common NAR subtype, making up approximately 71% of NAR diagnoses, with NARES making up the majority of the remaining NAR conditions. […] Applying the same frequency to the 450 million worldwide population suffering from NAR yields an estimate of a worldwide prevalence of VMR of 320 million. […] it is clear that VMR is, by far, the most common subtype of NAR with a significant burden of illness in the United States and worldwide.
#47 Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management
https://www.wjgnet.com/2222-0682/full/v6/i4/200.htm
Chronic rhinitis is a very common disease, as the prevalence in the general population resulted to be 40%. […] Non-allergic rhinitis has been estimated to account for 25%. […] In pediatrics, the diagnostic definition of non-allergic rhinitis has been often limited to the exclusion of an allergic sensitization. […] Actually, local allergic rhinitis has been often misdiagnosed as well as mixed rhinitis has not been recognized in most cases. […] Nasal cytology is a diagnostic procedure being suitable for routine clinical practice with children and could be a very useful tool to characterize and diagnose non-allergic rhinitis, providing important clues for epidemiological analysis and clinical management. […] Chronic rhinitis (CR) is a very common disease with an increasing incidence, especially in the Western countries, where the actual prevalence in the general population is between 10% and 40%, according to different studies.
#48
https://link.springer.com/article/10.1007/s40136-013-0013-x
The reported prevalence of NAR differs, similarly to the reported prevalence of AR. In a representative sample of the Belgian population (n = 4,959) with an overall prevalence of self-declared recent rhinitis symptoms of 39.3 %, AR was reported in 29.8 % of subjects and NAR in 9.6 % of subjects. […] Recently they showed that LAR is a common respiratory disease, with a prevalence of 25.7 % of the rhinitis population in their practice. […] For the diagnosis of LAR, an NAPT is needed. Further studies are needed to examine the prevalence of this phenomenon in different areas, to improve the diagnostic methods, and to develop therapeutic approaches.
#49
https://link.springer.com/article/10.1007/s40136-013-0013-x
The reported prevalence of NAR differs, similarly to the reported prevalence of AR. In a representative sample of the Belgian population (n = 4,959) with an overall prevalence of self-declared recent rhinitis symptoms of 39.3 %, AR was reported in 29.8 % of subjects and NAR in 9.6 % of subjects. […] Recently they showed that LAR is a common respiratory disease, with a prevalence of 25.7 % of the rhinitis population in their practice. […] For the diagnosis of LAR, an NAPT is needed. Further studies are needed to examine the prevalence of this phenomenon in different areas, to improve the diagnostic methods, and to develop therapeutic approaches.
#50 Worldwide prevalence of rhinitis in adults: A review of definitions and temporal evolution – Archive ouverte HAL
https://hal.science/hal-03642666
Worldwide prevalence of rhinitis in adults: A review of definitions and temporal evolution […] The majority of studies had focused on AR, while only a few epidemiological data exist on NAR. […] We found geographical variability in rhinitis prevalence. Most of studies reported an increase of rhinitis prevalence over the last decades.
#51 Allergic Rhinitis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/134825-overview
The prevalence of allergic rhinitis in the United States is estimated to be 7.7% affecting roughly 19.2 million adults each year. In 2018, 7.2% of children younger than 18 years reported symptoms of allergic rhinitis in the past 12 months. […] The development of allergic rhinitis before 20 years of age occurs in 80% of cases. […] Throughout the world, the prevalence of allergic rhinitis has slightly escalated. […] Currently, approximately 10 to 30% of adults and 40% of children are affected. […] The European Community Resporatory Health survey recorded a prevalence of 10 to 41% in adults with allergic rhinitis. […] Scandinavian studies have demonstrated a cumulative prevalence rate of 15% in men and 14% in women. […] The prevalence of allergic rhinitis may vary within and among countries.
#52 Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis
https://www.e-cep.org/journal/view.php?number=20125555352
Rhinitis is among the most common respiratory diseases in children. Nonallergic rhinitis accounts for 16%89% of the chronic rhinitis cases, affecting 1%50% (median 10%) of the total pediatric population. Nonallergic rhinitis is more prevalent during the first 2 years of life; however, its underestimation for children with atopic tendencies is likely due to low positive rates of specific allergic tests during early childhood. Studies have reported that the prevalence of nonallergic rhinitis is 0.7%50.0 % (median, 10.1%) in pediatric population. Nonallergic rhinitis seems to account for 15.7%89.0% of the chronic rhinitis cases. In epidemiologic studies, decreasing trends in the incidence of nonallergic rhinitis were observed, while the incidence of allergic rhinitis increased with age. Considering the data of the studies mentioned above, nonallergic rhinitis is found to be prevalent in children younger than 2 years with chronic rhinitis, and the proportion tends to decrease with age, whereas the proportion of allergic rhinitis increases.
#53 Clinical and Experimental Pediatrics
https://www.e-cep.org/m/journal/view.php?number=20125555352
A recent study of a Korean population reported that the prevalence of allergic rhinitis increased from 22.1% to 28.3% from 7 to 12 years of age, while that of nonallergic rhinitis decreased from 21.3% to 13.3%. […] Considering the data of the studies mentioned above, nonallergic rhinitis is found to be prevalent in children younger than 2 years with chronic rhinitis, and the proportion tends to decrease with age, whereas the proportion of allergic rhinitis increases. […] The prevalence of nonallergic rhinitis with eosinophilia syndrome is even lower. […] A correlation between nonallergic rhinitis and pollution has been suggested owing to the recent increase in nonallergic rhinitis rates in highly developing regions such as some Asian countries, but many aspects remain unknown. […] Here we review the prevalence, diagnosis, comorbidities, and treatment recommendations for nonallergic rhinitis versus allergic rhinitis in children.
#54 Worldwide prevalence of rhinitis in adults: A review of definitions and temporal evolution – Archive ouverte HAL
https://hal.science/hal-03642666
Worldwide prevalence of rhinitis in adults: A review of definitions and temporal evolution […] The majority of studies had focused on AR, while only a few epidemiological data exist on NAR. […] We found geographical variability in rhinitis prevalence. Most of studies reported an increase of rhinitis prevalence over the last decades.
#55 Allergic Rhinitis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/134825-overview
The prevalence of allergic rhinitis in the United States is estimated to be 7.7% affecting roughly 19.2 million adults each year. In 2018, 7.2% of children younger than 18 years reported symptoms of allergic rhinitis in the past 12 months. […] The development of allergic rhinitis before 20 years of age occurs in 80% of cases. […] Throughout the world, the prevalence of allergic rhinitis has slightly escalated. […] Currently, approximately 10 to 30% of adults and 40% of children are affected. […] The European Community Resporatory Health survey recorded a prevalence of 10 to 41% in adults with allergic rhinitis. […] Scandinavian studies have demonstrated a cumulative prevalence rate of 15% in men and 14% in women. […] The prevalence of allergic rhinitis may vary within and among countries.
#56 Allergic Rhinitis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/134825-overview
The prevalence of allergic rhinitis in the United States is estimated to be 7.7% affecting roughly 19.2 million adults each year. In 2018, 7.2% of children younger than 18 years reported symptoms of allergic rhinitis in the past 12 months. […] The development of allergic rhinitis before 20 years of age occurs in 80% of cases. […] Throughout the world, the prevalence of allergic rhinitis has slightly escalated. […] Currently, approximately 10 to 30% of adults and 40% of children are affected. […] The European Community Resporatory Health survey recorded a prevalence of 10 to 41% in adults with allergic rhinitis. […] Scandinavian studies have demonstrated a cumulative prevalence rate of 15% in men and 14% in women. […] The prevalence of allergic rhinitis may vary within and among countries.
#57 Allergic Rhinitis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/134825-overview
The prevalence of allergic rhinitis in the United States is estimated to be 7.7% affecting roughly 19.2 million adults each year. In 2018, 7.2% of children younger than 18 years reported symptoms of allergic rhinitis in the past 12 months. […] The development of allergic rhinitis before 20 years of age occurs in 80% of cases. […] Throughout the world, the prevalence of allergic rhinitis has slightly escalated. […] Currently, approximately 10 to 30% of adults and 40% of children are affected. […] The European Community Resporatory Health survey recorded a prevalence of 10 to 41% in adults with allergic rhinitis. […] Scandinavian studies have demonstrated a cumulative prevalence rate of 15% in men and 14% in women. […] The prevalence of allergic rhinitis may vary within and among countries.
#58 Allergic Rhinitis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/134825-overview
Highest prevalence of severe allergic rhinitis symptoms in children were observed in Africa and Latin America. […] While allergic rhinitis itself is not life-threatening (unless accompanied by severe asthma or anaphylaxis), morbidity from the condition can be significant. […] Allergic rhinitis often coexists with other disorders, such as asthma, and may be associated with asthma exacerbations. […] Allergic rhinitis is also associated with otitis media, eustachian tube dysfunction, sinusitis, nasal polyps, allergic conjunctivitis, and atopic dermatitis. […] Numerous complications that can lead to increased morbidity or even mortality can occur secondary to allergic rhinitis. […] Allergic rhinitis can frequently lead to significant impairment of quality of life. […] The prevalence of allergic rhinitis has been reported to be as high as 40% in children, subsequently decreasing with age.
#59 Clinical and Experimental Pediatrics
https://www.e-cep.org/m/journal/view.php?number=20125555352
A recent study of a Korean population reported that the prevalence of allergic rhinitis increased from 22.1% to 28.3% from 7 to 12 years of age, while that of nonallergic rhinitis decreased from 21.3% to 13.3%. […] Considering the data of the studies mentioned above, nonallergic rhinitis is found to be prevalent in children younger than 2 years with chronic rhinitis, and the proportion tends to decrease with age, whereas the proportion of allergic rhinitis increases. […] The prevalence of nonallergic rhinitis with eosinophilia syndrome is even lower. […] A correlation between nonallergic rhinitis and pollution has been suggested owing to the recent increase in nonallergic rhinitis rates in highly developing regions such as some Asian countries, but many aspects remain unknown. […] Here we review the prevalence, diagnosis, comorbidities, and treatment recommendations for nonallergic rhinitis versus allergic rhinitis in children.
#60 Allergic Rhinitis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/134825-overview
Highest prevalence of severe allergic rhinitis symptoms in children were observed in Africa and Latin America. […] While allergic rhinitis itself is not life-threatening (unless accompanied by severe asthma or anaphylaxis), morbidity from the condition can be significant. […] Allergic rhinitis often coexists with other disorders, such as asthma, and may be associated with asthma exacerbations. […] Allergic rhinitis is also associated with otitis media, eustachian tube dysfunction, sinusitis, nasal polyps, allergic conjunctivitis, and atopic dermatitis. […] Numerous complications that can lead to increased morbidity or even mortality can occur secondary to allergic rhinitis. […] Allergic rhinitis can frequently lead to significant impairment of quality of life. […] The prevalence of allergic rhinitis has been reported to be as high as 40% in children, subsequently decreasing with age.
#61 AAIR :: Allergy, Asthma & Immunology Research
https://e-aair.org/DOIx.php?id=10.4168/aair.2011.3.3.148
Beyond these physical and emotional impacts on patients there is also an economic burden from the incomplete diagnosis and treatment of rhinitis. Recent evidence shows that asthma and rhinitis are often coexisting in atopic and nonatopic patients and that effective treatment of rhinitis frequently improves asthma.
#62 Allergic Rhinitis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/134825-overview
Highest prevalence of severe allergic rhinitis symptoms in children were observed in Africa and Latin America. […] While allergic rhinitis itself is not life-threatening (unless accompanied by severe asthma or anaphylaxis), morbidity from the condition can be significant. […] Allergic rhinitis often coexists with other disorders, such as asthma, and may be associated with asthma exacerbations. […] Allergic rhinitis is also associated with otitis media, eustachian tube dysfunction, sinusitis, nasal polyps, allergic conjunctivitis, and atopic dermatitis. […] Numerous complications that can lead to increased morbidity or even mortality can occur secondary to allergic rhinitis. […] Allergic rhinitis can frequently lead to significant impairment of quality of life. […] The prevalence of allergic rhinitis has been reported to be as high as 40% in children, subsequently decreasing with age.
#63 Prevalence of allergic and nonallergic rhinitis in a rural area of northern China based on sensitization to specific aeroallergens | Allergy, Asthma & Clinical Immunology | Full Text
https://aacijournal.biomedcentral.com/articles/10.1186/s13223-018-0299-9
In this study, we found that family history of AR, and comorbid asthma, CRS, or atopic dermatitis, were all associated with increased risk of both AR and NAR. […] It is possible that the variability may additionally result from differences in both training and comprehension of the disease by investigators in different centers, as adopting face-to-face interviews has shown the prevalence of AR to vary from 6.24% to 32.5%. […] To our knowledge the present study is the first to provide such epidemiological data on both clinically diagnosed AR and NAR in a rural area of northern China, using a combination of self-reported AR and objective assessment of sensitization to specific aeroallergens by SPT.
#64 A pilot study demonstrating the evidence for reflux disease in patients presenting with non-allergic rhinitis (NAR)âreflux disease in association with non-allergic rhinitis – Wang – Annals of Esophagus
https://aoe.amegroups.org/article/view/4765/html
Patients with NAR displayed positive for reflux disease due to the significant concentration of pepsin present, specifically in the postprandial sample. […] The ease of Peptest provided quick and cost effective results and provided a clear link between NAR and reflux-disease. […] The data generated in the study demonstrated that there was a high level of pepsin in patient saliva samples compared to the healthy control population, providing a clear link and association of reflux disease in patients presenting with NAR. […] Physicians treating patients with NAR should consider reflux treatment for patients presenting with high pepsin concentrations.
#65 A pilot study demonstrating the evidence for reflux disease in patients presenting with non-allergic rhinitis (NAR)âreflux disease in association with non-allergic rhinitis – Wang – Annals of Esophagus
https://aoe.amegroups.org/article/view/4765/html
Patients with NAR displayed positive for reflux disease due to the significant concentration of pepsin present, specifically in the postprandial sample. […] The ease of Peptest provided quick and cost effective results and provided a clear link between NAR and reflux-disease. […] The data generated in the study demonstrated that there was a high level of pepsin in patient saliva samples compared to the healthy control population, providing a clear link and association of reflux disease in patients presenting with NAR. […] Physicians treating patients with NAR should consider reflux treatment for patients presenting with high pepsin concentrations.
#66 Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management
https://www.wjgnet.com/2222-0682/full/v6/i4/200.htm
Despite such an epidemiological burden, CR have been considered mild disorders and that poor consideration contributed to underestimate such a diagnosis and, as a consequence, the real prevalence for long time. […] Actually, a lot of studies focused on allergic rhinitis (AR), representing the most diagnosed type of CR, and showed that nasal symptoms often interfere with daily activities and alter the sleep pattern, leading to negative consequences on the social life and intellectual performances. […] All these aspects make CR be a global health issue characterized with significant direct and indirect costs for the society. […] In general, an allergic etiology, namely AR, can be established only in around half adult cases of CR, which indicates that a significant portion of the problem is represented by NAR.
#67 Allergic Rhinitis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/134825-overview
Highest prevalence of severe allergic rhinitis symptoms in children were observed in Africa and Latin America. […] While allergic rhinitis itself is not life-threatening (unless accompanied by severe asthma or anaphylaxis), morbidity from the condition can be significant. […] Allergic rhinitis often coexists with other disorders, such as asthma, and may be associated with asthma exacerbations. […] Allergic rhinitis is also associated with otitis media, eustachian tube dysfunction, sinusitis, nasal polyps, allergic conjunctivitis, and atopic dermatitis. […] Numerous complications that can lead to increased morbidity or even mortality can occur secondary to allergic rhinitis. […] Allergic rhinitis can frequently lead to significant impairment of quality of life. […] The prevalence of allergic rhinitis has been reported to be as high as 40% in children, subsequently decreasing with age.
#68 Nonallergic rhinitis: Common problem, chronic symptoms | MDedge
https://ma1.mdedge.com/content/nonallergic-rhinitis-common-problem-chronic-symptoms
Regardless of the type, untreated or uncontrolled symptoms of rhinitis can significantly affect the quality of life. […] Nonallergic rhinitis encompasses a range of syndromes with overlapping symptoms. […] The diagnosis of nonallergic rhinitis depends on a thorough history and physical examination. Key questions relate to the triggers that bring on the rhinitis, which will assist the clinician in determining which subtype of rhinitis a patient may be experiencing and therefore how to manage it. […] Many patients with nonallergic rhinitis find that antihistamines have no benefit. Also, they do not have other atopic diseases such as eczema or food allergies and have no family history of atopy. […] Patients for whom an allergic cause cannot be found by allergy skin testing or serum specific IgE immunoassay (Immunocap/RAST) for environmental aeroallergens are classified as having nonallergic rhinitis.
#69 AAIR :: Allergy, Asthma & Immunology Research
https://e-aair.org/DOIx.php?id=10.4168/aair.2011.3.3.148
Nonallergic rhinitis (NAR) is generally described as chronic nasal symptoms, such as obstruction and rhinorrhea that occur in relation to nonallergic, noninfectious triggers such as change in the weather, exposure to caustic odors or cigarette smoke, barometric pressure differences, etc. […] The exact prevalence and impact of NAR is not as established as it is for allergic rhinitis. It is estimated that it affects more than 19 to 20 million patients in the United States, with vasomotor rhinitis being the most common subtype seen. […] With many subtypes of disease, the true economic burden of NAR is most likely grossly underestimated. […] As Ledford points out in his symposium on assessing the damage of inadequately diagnosed NAR, patients are often empirically treated with oral second generation antihistamines, which are usually not sufficient in relieving their symptoms.
#70 Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management
https://www.wjgnet.com/2222-0682/full/v6/i4/200.htm
Despite such an epidemiological burden, CR have been considered mild disorders and that poor consideration contributed to underestimate such a diagnosis and, as a consequence, the real prevalence for long time. […] Actually, a lot of studies focused on allergic rhinitis (AR), representing the most diagnosed type of CR, and showed that nasal symptoms often interfere with daily activities and alter the sleep pattern, leading to negative consequences on the social life and intellectual performances. […] All these aspects make CR be a global health issue characterized with significant direct and indirect costs for the society. […] In general, an allergic etiology, namely AR, can be established only in around half adult cases of CR, which indicates that a significant portion of the problem is represented by NAR.
#71 Diagnosing Rhinitis: Allergic vs. Nonallergic | AAFP
https://www.aafp.org/pubs/afp/issues/2006/0501/p1583.html
The diagnosis of nonallergic rhinitis is made after eliminating allergic or IgE-mediated causes. The most common cause of nonallergic rhinitis is an acute viral infection. Less common chronic causes include vasomotor rhinitis, hormonal rhinitis, non-allergic rhinitis with eosinophilia syndrome, occupational rhinitis (irritant subtype), gustatory rhinitis, rhinitis medicamentosa, and drug-induced rhinitis. […] Controversy surrounds nonallergic rhinitis because the epidemiology and diagnostic criteria are confusing. The main controversy is how to differentiate allergic rhinitis from nonallergic rhinitis. Furthermore, current research appears to delineate a third category that includes characteristics of both allergic and nonallergic rhinitis. Research shows that the prevalence of pure allergic rhinitis in the adult population with symptoms is 43 percent, combination allergic rhinitis and nonallergic rhinitis is 34 percent, and pure nonallergic rhinitis is 23 percent. […] Management of allergic and nonallergic rhinitis is slightly different; therefore, as more clinical data become available, determining the difference between the two types will become more important.
#72 Non-allergic rhinitis – Symptoms, diagnosis and treatment | BMJ Best Practice US
https://bestpractice.bmj.com/topics/en-us/231
For non-allergic rhinitis, traditional triggers such as cat or dog exposure should be absent. […] A diagnosis of NAR requires negative specific IgE responses by skin or serologic testing. […] Environmental tobacco smoke, perfumes and fragrances, as well as temperature and barometric changes may aggravate symptoms in NAR, but specific IgE responses by skin or serologic testing are all negative. […] The presence of eosinophils in the nasal mucosa in NARES distinguishes it from other subtypes of NAR. […] To establish a definitive diagnosis of NAR, all other chronic rhinitis syndromes should be properly considered and excluded.
#73 Non-allergic rhinitis – Symptoms, diagnosis and treatment | BMJ Best Practice
https://bestpractice.bmj.com/topics/en-gb/231
For non-allergic rhinitis, traditional triggers such as cat or dog exposure should be absent. […] A diagnosis of NAR requires negative specific IgE responses by skin or serological testing. […] Environmental tobacco smoke, perfumes and fragrances, as well as temperature and barometric changes may aggravate symptoms in NAR, but specific IgE responses by skin or serological testing are all negative. […] The presence of eosinophils in the nasal mucosa in NARES distinguishes it from other sub-types of NAR. […] To establish a definitive diagnosis of NAR, all other chronic rhinitis syndromes should be properly considered and excluded.
#74 Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management
https://www.wjgnet.com/2222-0682/full/v6/i4/200.htm
Chronic rhinitis is a very common disease, as the prevalence in the general population resulted to be 40%. […] Non-allergic rhinitis has been estimated to account for 25%. […] In pediatrics, the diagnostic definition of non-allergic rhinitis has been often limited to the exclusion of an allergic sensitization. […] Actually, local allergic rhinitis has been often misdiagnosed as well as mixed rhinitis has not been recognized in most cases. […] Nasal cytology is a diagnostic procedure being suitable for routine clinical practice with children and could be a very useful tool to characterize and diagnose non-allergic rhinitis, providing important clues for epidemiological analysis and clinical management. […] Chronic rhinitis (CR) is a very common disease with an increasing incidence, especially in the Western countries, where the actual prevalence in the general population is between 10% and 40%, according to different studies.
#75 Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management
https://www.wjgnet.com/2222-0682/full/v6/i4/200.htm
Chronic rhinitis is a very common disease, as the prevalence in the general population resulted to be 40%. […] Non-allergic rhinitis has been estimated to account for 25%. […] In pediatrics, the diagnostic definition of non-allergic rhinitis has been often limited to the exclusion of an allergic sensitization. […] Actually, local allergic rhinitis has been often misdiagnosed as well as mixed rhinitis has not been recognized in most cases. […] Nasal cytology is a diagnostic procedure being suitable for routine clinical practice with children and could be a very useful tool to characterize and diagnose non-allergic rhinitis, providing important clues for epidemiological analysis and clinical management. […] Chronic rhinitis (CR) is a very common disease with an increasing incidence, especially in the Western countries, where the actual prevalence in the general population is between 10% and 40%, according to different studies.
#76 Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management
https://www.wjgnet.com/2222-0682/full/v6/i4/200.htm
Chronic rhinitis is a very common disease, as the prevalence in the general population resulted to be 40%. […] Non-allergic rhinitis has been estimated to account for 25%. […] In pediatrics, the diagnostic definition of non-allergic rhinitis has been often limited to the exclusion of an allergic sensitization. […] Actually, local allergic rhinitis has been often misdiagnosed as well as mixed rhinitis has not been recognized in most cases. […] Nasal cytology is a diagnostic procedure being suitable for routine clinical practice with children and could be a very useful tool to characterize and diagnose non-allergic rhinitis, providing important clues for epidemiological analysis and clinical management. […] Chronic rhinitis (CR) is a very common disease with an increasing incidence, especially in the Western countries, where the actual prevalence in the general population is between 10% and 40%, according to different studies.
#77 Prevalence of allergic and nonallergic rhinitis in a rural area of northern China based on sensitization to specific aeroallergens | Allergy, Asthma & Clinical Immunology | Full Text
https://aacijournal.biomedcentral.com/articles/10.1186/s13223-018-0299-9
Most epidemiologic studies reporting prevalence of allergic rhinitis (AR) and nonallergic rhinitis (NAR) have assessed solely self-reported prevalence, without confirmation by objective measures. […] Thus, we aimed to explore the prevalence and risk factors of AR and NAR in a Chinese, based on both clinical manifestation and allergic status. […] The confirmed standardized prevalence of AR and NAR were 16.78% and 24.60%, respectively. […] Combination of standardized questionnaires and specific allergen tests may provide more accurate estimates of prevalence of AR and NAR and associated risk factors. […] Few epidemiologic studies have been reported on NAR, and most of the studies have concentrated solely on the self-reported prevalence. […] The aim of the present study was therefore to assess the prevalence of clinical AR and NAR, using both subjective and objective tests, and the associated risk factors in Chinese subjects from a rural community in Beijing, China.
#78 Non Allergic Rhinitis: Prevalence, Clinical Profile and Knowledge Gaps in Literature
https://pmc.ncbi.nlm.nih.gov/articles/PMC3251201/
Prevalence of NAR in Oman was found to be 57% of the rhinitis population, these figures are very similar to the ones mentioned in literature. […] Many knowledge gaps exist in the literature with relations to pathogenesis, clinical and laboratory diagnosis and there is a large knowledge gap with reference to medical as well as surgical outcomes.
#79 Non Allergic Rhinitis: Prevalence, Clinical Profile and Knowledge Gaps in Literature
https://pmc.ncbi.nlm.nih.gov/articles/PMC3251201/
Although Nasal symptoms induced by Non-allergic rhinitis| (NAR) are a cause of wide spread morbidity; the disease is trivialized. There is a lack of Epidemiological studies on the prevalence of non-allergic rhinitis. […] The overall prevalence of rhinitis was 18.5% (n=113). The prevalence of NAR was 7.5% (n=46). […] The knowledge gap study which consisted of the assessment and review of 115 Medline titles including 4 systematic reviews, and 34 research papers, as well as 2 recent otolaryngology text books revealed that no study on the prevalence of NAR from Oman. Although the recent text now clearly defines NAR, there is scant literature on the prevalence, diagnosis and management outcomes of NAR in the literature. […] The prevalence of pure chronic NAR represents 17-52% amongst the rhinitis population.
#80 Nonallergic Rhinitis | IntechOpen
https://www.intechopen.com/chapters/1180286
Non-allergic rhinitis (NAR) is a heterogeneous nasal disease with high global prevalence. […] Limited data are available regarding the prevalence of general rhinitis, with even fewer statistics on Nonallergic rhinitis. However, estimates indicate that over 70 million individuals in the United States and 200 million globally are affected by chronic rhinitis. […] The absence of prevalence data for nonallergic rhinitis is attributed to the lack of a standardized definition and diagnostic criteria, as highlighted by Hellings. […] Savoure et al. perform a study of worldwide prevalence of rhinitis and described unspecified rhinitis prevalence at 29.4% (1.1 to 63.3%), allergic rhinitis with 18.1% (1 to 54.5%) and 12% for nonallergic rhinitis (4 to 31.4%). […] Dykewicz et al. estimated nonallergic rhinitis affect 1752% of adults in the United States and 34% may have a mixed rhinitis. […] An important difference between nonallergic and allergic rhinitis is the seasonality of symptoms. Savoure et al. referred allergic rhinitis increased from March to June (spring) and nonallergic rhinitis increased during winter and decreases from May to September.
#81 The prevalence of nonâallergic rhinitis phenotypes in the general population: A crossâsectional study
https://pmc.ncbi.nlm.nih.gov/articles/PMC9306544/
The prevalence of nonallergic rhinitis (NAR) phenotypes in the general population is currently unknown. […] The prevalence of chronic rhinitis in the general population was 40% (N = 558, of those, 65% had NAR and 28% AR, in 7% allergy status is unknown). […] This is the first study to describe the prevalences of NAR phenotypes in the general population. […] Our data on the prevalence of phenotypes may help clinicians to anticipate the type of patients at their clinic and help guide a tailored treatment approach. […] The high prevalence of rhinitis medicamentosa is alarming, since this is a potentially preventable phenotype. […] We found a prevalence of NAR of 28% in the general population. […] The aim of this study was to determine the prevalence of NAR phenotypes in the general population.
#82 The prevalence of nonâallergic rhinitis phenotypes in the general population: A crossâsectional study
https://pmc.ncbi.nlm.nih.gov/articles/PMC9306544/
This is the first paper that describes the prevalence of NAR phenotypes in the general population. […] The second most common phenotype was RM (17% of NAR). […] A high prevalence of RM is a major concern, seeing that this is a preventable phenotype, and warrants attention in our daily practice because it is something often not spontaneously mentioned by our patients.
#83 Rhinitis, Cold Air-Induced | 5-Minute Clinical Consult
https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816428/all/Rhinitis__Cold_Air_Induced
Overall epidemiology of rhinitis conditions is difficult to assess due to challenges in classifying rhinitis. […] Prevalence of cold air sensitivity in nonallergic chronic rhinitis is not known. […] Rhinitis is a very common disorder affecting 20-40% of the Western population. […] Most ENT clinics report a 50-50 division between allergic and nonallergic patients. […] Nonallergic rhinitis presents later in life than allergic rhinitis, with 70% of patients presenting after 20 years of age. […] The prevalence of nonallergic rhinitis in children is not well studied.
#84 Clinical and Experimental Pediatrics
https://www.e-cep.org/m/journal/view.php?number=20125555352
A recent study of a Korean population reported that the prevalence of allergic rhinitis increased from 22.1% to 28.3% from 7 to 12 years of age, while that of nonallergic rhinitis decreased from 21.3% to 13.3%. […] Considering the data of the studies mentioned above, nonallergic rhinitis is found to be prevalent in children younger than 2 years with chronic rhinitis, and the proportion tends to decrease with age, whereas the proportion of allergic rhinitis increases. […] The prevalence of nonallergic rhinitis with eosinophilia syndrome is even lower. […] A correlation between nonallergic rhinitis and pollution has been suggested owing to the recent increase in nonallergic rhinitis rates in highly developing regions such as some Asian countries, but many aspects remain unknown. […] Here we review the prevalence, diagnosis, comorbidities, and treatment recommendations for nonallergic rhinitis versus allergic rhinitis in children.