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Allergic rhinitis: diagnosis
Last reviewed: 23.04.2024
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Physical examination
Diagnosis of allergic rhinitis consists of a complex of clinical and laboratory methods of investigation, it is important to carefully collect the history, analyze complaints, local and general methods of examination.
When examining the nasal cavity with a rhinoscope, and with the help of an endoscope, characteristic changes are observed: edema of the mucous membrane of the nasal conchae of various degrees, pallor of the mucous membrane, sometimes with a bluish tinge, watery or foamy. In the embodiment of the flow in the nasal passages, exudate is found. Exudate, as a rule, serous. In these cases, the patient is diagnosed with allergic rhinosinusitis. Occasionally, polyposive growths, mainly from the mid-nasal passage, are detected. It is often possible to distinguish polypoid hyperplasia of the middle nasal shell.
Laboratory research
In clinical practice, skin tests are widely used to determine the type of allergen. Thanks to the standardization of allergens and the development of diagnostic test systems of adequate quality, it has been possible to significantly improve the diagnosis of most inhalant allergens. With the proper implementation of skin tests, it is more likely to determine the presence of hypersensitivity to certain agents. However, given the complexity of the technique and the interpretation of the results, such tests should be conducted in an allergological facility.
Also, reliable methods are used to determine the level of allergen-specific IgE in the blood serum. For this, allergosorbent (RAST) and radioimmunosorbent (PRIST) tests are used.
- RAST is a test that allows to detect an increase in IgE concentration in serum. It can be used both during the period of exacerbation, and during remission.
- PRIST - the test is used to determine the level of radioactive complexes with the help of a gamma-ray meter. The determination of the level of specific IgE in the serum for diagnostic significance is comparable to skin tests.
These methods are used only in cases where specific immunotherapy is planned, or in cases where careful collection of an anamnesis fails to verify the allergen.
Also, a method is used to study smears-prints from the mucous membrane of the nasal cavity. In this case, clusters of eosinophils, goblet and mast cells are identified.
Instrumental research
With the help of CT of paranasal sinuses, it is possible to diagnose a parietal thickening of the mucous membrane of the paranasal sinuses, differentiate variants of allergic rhinitis.
Indications for consultation of other specialists
Survey of patients with suspected allergic rhinitis is expedient to conduct with the participation of an allergist.
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