Allergic rhinitis is an intermittent or persistent inflammation of the mucous membrane of the upper respiratory tract, characterized by nasal congestion, discharge, itching, sneezing, and a combination of several symptoms is possible. In this situation, a 35-year-old patient presented with nasal congestion, eyelid edema, conjunctival erythema, allergic folds and spangles, and inflamed nostrils, which confirms her diagnosis (Seidman et al., 2015). A medical specialist identified some of the symptoms listed.
The hypersensitivity reaction is the first type since allergic rhinitis is determined by it. The allergen, having entered the body for the first time, causes the appearance of specific antibodies, immunoglobulins, which are fixed on the surface of mast cells. Upon repeated contact of an already sensitized organism with an irritant, IgE-dependent activation of mast cells occurs (Hoyte & Nelson, 2018). This process causes the release of histamine, heparin, and other inflammatory mediators responsible for the manifestation of allergic reactions. In fact, pathophysiology implies that the initial intake of the allergen causes the production of IgE by plasma cells.
Three subjective conclusions from this situation are: the patient experiences constant sneezing, considers the complication of infectious diseases and describes improvement away from home in a different climate. A specialist established objective conclusions: firstly, eyelid edema and allergic sheen caused by venous edema of the lower eyelid. In other words, allergies give inflammation to the eyes. Secondly, inflamed nostrils and an allergic fold indicate a stable runny nose. Thirdly, the constancy of these signs shows the constant close presence of a source of irritation.
First of all, it is necessary to pass tests for sources of irritation, which are taken by the method of a swab from the nose. Based on the findings, pharmacological treatment with antihistamines and corticosteroid nasal sprays and decongestants is then prescribed to reduce congestion and symptoms (Hoyte & Nelson, 2018). Equally important are environmental control and nasal irrigation (Schuler IV & Montejo, 2021). Finally, as a consequence, as little contact with known allergens as possible should be ensured. In this case, the symptoms appeared around the same time as the cat appeared in the house. Since humans often show hypersensitivity to animal saliva, this option is very likely to be used as a hypothesis.
Thus, the following approach is required. First of all, pharmacological treatment with intranasal antihistamines and reduction of contact with the cat is necessary if the source of hypersensitivity is confirmed (Seidman et al., 2015). If the proposed treatment is ineffective, it is necessary to resort to more complex pharmacological treatment or surgical interventions in the nasal area (Seidman et al., 2015). Antihistamine class of drugs and decongestants are offered as pharmacological treatment.
Fexofenadine is the pharmacologically active metabolite of terfenadine; it does not have a sedative effect. The antihistamine effect appears after 1 hour, reaching a maximum after 6 hours, lasting for 24 hours. After 28 days of the administration, no addiction is observed, which is an achievement compared to similar drugs of the previous generation (Klimek et al., 2019). Phenylephrine is presented as a part of combined preparations for treating acute respiratory viral infections, and influenza is used to achieve a moderate vasoconstrictive effect. Reduces swelling and hyperemia of the nasal mucosa by stimulating α1-adrenergic receptors (Klimek et al., 2019). In this situation, the abuse of intranasal vasoconstrictor drugs, which can be addictive and only eliminate symptoms, is not recommended. It is also not recommended to wear masks and other personal protective equipment that restricts the respiratory system.
References
Hoyte, F. C., & Nelson, H. S. (2018). Recent advances in allergic rhinitis. F1000Research, 7.
Klimek, L., Sperl, A., Becker, S., Mösges, R., & Tomazic, P. V. (2019). Current therapeutical strategies for allergic rhinitis.Expert Opinion on Pharmacotherapy, 20(1), 83-89. Web.
Schuler IV, C. F., & Montejo, J. M. (2021). Allergic rhinitis in children and adolescents.Immunology and Allergy Clinics, 41(4), 613-625. Web.
Seidman, M. D., Gurgel, R. K., Lin, S. Y., Schwartz, S. R., Baroody, F. M., Bonner, J. R.,… & Nnacheta, L. C. (2015). Clinical practice guideline: allergic rhinitis executive summary.Otolaryngology–Head and Neck Surgery, 152(2), 197-206. Web.