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Rhinitis, Nonallergic

David L. Riegleman, MD, Connie Y. Chung, MD and Sabrina L. Silver, DO, CAQSM Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Nonallergic rhinitis (NAR) is a syndrome composed of relapsing and remitting nasal congestion, rhinorrhea, postnasal drainage, and/or sneezing.

  • Symptoms range from mild to severe and ...

DIAGNOSIS

HISTORY

  • Congestion

  • Rhinorrhea

  • Postnasal drainage

  • Sneezing

  • Absence of nasal and ocular itching

  • Symptoms occur throughout the year, with exacerbation of symptoms with weather changes, respiratory ir...

TREATMENT

GENERAL MEASURES

  • Avoidance of known triggers

  • Topical intranasal glucocorticoids, topical antihistamines, and ipratropium have shown to be beneficial (2)[A].

  • Treatments effective for allergic rh...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Follow-up plan should be based on the individual’s response to treatment.

  • NAR will usually be a chronic condition and will require daily long-term treatment.

DIET

  • Av...

REFERENCES

1
Rondón C, Campo P, Togias A, et al. Local allergic rhinitis: concept, pathophysiology, and management. J Allergy Clin Immunol.  2012;129(6):1460–1467. [View Abstract on OvidMedline]
2
L...

ADDITIONAL READING

  • Campo P, Rondón C, Gould HJ, et al. Local IgE in non-allergic rhinitis. Clin Exp Allergy.  2015;45(5):872–881. [View Abstract on OvidMedline]

  • Kaliner MA, Baraniuk JN, Benninger ...

CODES

ICD10

  • J31.0 Chronic rhinitis

  • J00 Acute nasopharyngitis [common cold]

  • J30.0 Vasomotor rhinitis

ICD9

  • 472.0 Chronic rhinitis

  • 460 Acute nasopharyngitis [common cold]

SNOMED

  • 311000119101 non-allergic rhiniti...

CLINICAL PEARLS

  • NAR shares many symptoms with allergic rhinitis but is not mediated by the systemic IgE pathway.

  • NAR and allergic rhinitis may coexist (mixed rhinitis).

  • Topical treatment with intranasal...

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