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Allergic Rhinitis - Diagnosis
Last reviewed: 04.07.2025
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Physical examination
Diagnosis of allergic rhinitis consists of a complex of clinical and laboratory research methods; careful collection of anamnesis, analysis of complaints, local and general examination methods are of great importance.
When examining the nasal cavity with a rhinoscopy, and if possible with an endoscope, characteristic changes are determined: swelling of the mucous membrane of the nasal turbinates of varying degrees of severity, paleness of the mucous membrane, sometimes with a bluish tint, watery or foamy discharge. In the exudative variant of the course, exudate is found in the nasal passages. The exudate is usually serous. In these cases, the patient is diagnosed with allergic rhinosinusitis. Sometimes polypous growths are found, mainly originating from the middle nasal passage. Polypoid hyperplasia of the middle nasal turbinate can often be identified.
Laboratory research
Skin tests to determine the type of allergen are widely used in clinical practice. Standardization of allergens and development of adequate quality diagnostic test systems have significantly improved diagnostics for most inhalation allergens. When skin tests are performed correctly, hypersensitivity to certain agents can be determined with a higher degree of probability. However, given the complexity of the methodology and interpretation of the results, such tests must be performed in an allergological institution.
Methods that determine the level of allergen-specific IgE in the blood serum are also considered reliable. Allergosorbent (RAST) and radioimmunosorbent (PRIST) tests are used for this purpose.
- RAST is a test that detects increased IgE concentrations in the blood serum. It can be used both during exacerbation and remission.
- PRIST - the test is used to determine the level of radioactive complexes using a gamma emitter counter. Determination of the level of specific IgE in the blood serum is comparable in diagnostic significance to skin tests.
These methods are used only in cases where specific immunotherapy is planned, or in cases where careful collection of anamnesis fails to verify the allergen.
A method of studying smears-prints from the mucous membrane of the nasal cavity is also used. In this case, clusters of eosinophils, goblet cells and mast cells are detected.
Instrumental research
Using CT of the paranasal sinuses, it is possible to diagnose parietal thickening of the mucous membrane of the paranasal sinuses and differentiate variants of allergic rhinitis.
Indications for consultation with other specialists
It is advisable to conduct examination of patients with suspected allergic rhinitis with the participation of an allergist.
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