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Rhinorrhea

MedGen UID:
226777
Concept ID:
C1260880
Sign or Symptom
Synonyms: Nose, Runny; Runny Nose
SNOMED CT: Nasal discharge (64531003); Snuffles (397746007); Rhinorrhea (64531003); Nasal catarrh (64531003); Discharge from nose (64531003); Nasal discharge present (267101005); Nose running (267101005); Nose dripping (267101005)
 
HPO: HP:0031417

Definition

Increased discharge of mucus from the nose. [from HPO]

Term Hierarchy

Conditions with this feature

Hereditary mucoepithelial dysplasia
MedGen UID:
220887
Concept ID:
C1274795
Congenital Abnormality
Hereditary mucoepithelial dysplasia (HMD) is a rare autosomal dominant genodermatosis characterized by onset in infancy of a panepithelial defect involving the oral, nasal, conjunctival, vaginal, cervical, perineal, urethral, and bladder mucosa. Patients develop cataracts, blindness, nonscarring alopecia, perineal psoriasiform lesions, and follicular keratoses (Witkop et al., 1982). Although 1 family was reported to have progressive severe interstitial lung disease (Witkop et al., 1979), this feature has not been reported in other families and is not considered a criterion for diagnosis. However, the clinical triad of nonscarring alopecia, well-demarcated fiery red mucosa, and psoriasiform perineal involvement has been consistently observed (review by Boralevi et al., 2005).
Paroxysmal extreme pain disorder
MedGen UID:
331565
Concept ID:
C1833661
Disease or Syndrome
SCN9A neuropathic pain syndromes (SCN9A-NPS) comprise SCN9A erythromelalgia (EM), SCN9A paroxysmal extreme pain disorder (PEPD), and SCN9A small fiber neuropathy (SFN). SCN9A-EM is characterized by recurrent episodes of bilateral intense, burning pain, and redness, warmth, and occasionally swelling. While the feet are more commonly affected than the hands, in severely affected individuals the legs, arms, face, and/or ears may be involved. SCN9A-PEPD is characterized by neonatal or infantile onset of autonomic manifestations that can include skin flushing, harlequin (patchy or asymmetric) color change, tonic non-epileptic attacks (stiffening), and syncope with bradycardia. Later manifestations are episodes of excruciating deep burning rectal, ocular, or submandibular pain accompanied by flushing (erythematous skin changes). SCN9A-SFN is characterized by adult-onset neuropathic pain in a stocking and glove distribution, often with a burning quality; autonomic manifestations such as dry eyes, mouth, orthostatic dizziness, palpitations, bowel or bladder disturbances; and preservation of large nerve fiber functions (normal strength, tendon reflexes, and vibration sense).
Cluster headache, familial
MedGen UID:
350040
Concept ID:
C1861513
Disease or Syndrome
The Headache Classification Committee of the International Headache Society (1988) listed the following criteria for cluster headache (CH): at least 5 attacks of severe unilateral orbital, supraorbital, and/or temporal pain, lasting 15 to 180 minutes, associated with at least 1 of 8 local autonomic signs, and occurring once every other day to 8 per day. Approximately 85% of CH patients have the episodic subtype, in which the headaches occur in cluster periods lasting from 7 days to 1 year and separated by attack-free intervals of 1 month or more. The remainder of patients have the chronic subtype, in which attacks recur for greater than 1 year without remission or with remissions lasting less than 1 month (Lipton et al., 2004).
Primary ciliary dyskinesia 14
MedGen UID:
462486
Concept ID:
C3151136
Disease or Syndrome
Primary ciliary dyskinesia-14 (CILD14) is an autosomal recessive disorder characterized by recurrent respiratory infections associated with defects in ciliary inner dynein arms and axonemal disorganization (Merveille et al., 2011). For a general phenotypic description and a discussion of genetic heterogeneity of primary ciliary dyskinesia, see CILD1 (244400).
Primary ciliary dyskinesia 15
MedGen UID:
462487
Concept ID:
C3151137
Disease or Syndrome
Primary ciliary dyskinesia-15 (CILD15) is an autosomal recessive disorder characterized by recurrent respiratory infections associated with defects in ciliary inner dynein arms and axonemal disorganization (summary by Becker-Heck et al., 2011). For a general phenotypic description and a discussion of genetic heterogeneity of primary ciliary dyskinesia, see CILD1 (244400).
Granulomatosis with polyangiitis
MedGen UID:
811223
Concept ID:
C3495801
Disease or Syndrome
Granulomatosis with polyangiitis, formerly termed Wegener granulomatosis, is a systemic disease with a complex genetic background. It is characterized by necrotizing granulomatous inflammation of the upper and lower respiratory tract, glomerulonephritis, vasculitis, and the presence of antineutrophil cytoplasmatic autoantibodies (ANCAs) in patient sera. These ANCAs are antibodies to a defined target antigen, proteinase-3 (PR3, PRTN3; 177020), which is present within primary azurophil granules of neutrophils (PMNs) and lysozymes of monocytes. On cytokine priming of PMNs, PR3 translocates to the cell surface, where PR3-ANCAs can interact with their antigens and activate PMNs. PMNs from patients with active GPA express PR3 on their surface, produce respiratory burst, and release proteolytic enzymes after activation with PR3-ANCAs. The consequence is a self-sustaining inflammatory process (Jagiello et al., 2004).
Primary ciliary dyskinesia 20
MedGen UID:
761920
Concept ID:
C3540844
Disease or Syndrome
CILD20 is an autosomal recessive ciliopathy characterized by infantile onset of chronic sinopulmonary infections resulting from immotile cilia and defective clearance. Patients may also have situs inversus or cardiac anomalies. Electron microscopy of respiratory epithelial cells shows absence of the outer dynein arms. Unlike other forms of CILD, patients with CILD20 do not appear to be infertile. For a phenotypic description and a discussion of genetic heterogeneity of primary ciliary dyskinesia, see 244400.
Ciliary dyskinesia, primary, 37
MedGen UID:
1615746
Concept ID:
C4539798
Disease or Syndrome
Ciliary dyskinesia, primary, 39
MedGen UID:
1648363
Concept ID:
C4748841
Disease or Syndrome
Primary ciliary dyskinesia-39 (CILD39) is an autosomal recessive disorder characterized by chronic sinopulmonary infections beginning soon after birth and laterality defects in about 50% of patients. Although patient nasal ciliary samples have normal structure, detailed studies may show ciliary kinetic defects in some patients (summary by Bonnefoy et al., 2018). For a phenotypic description and a discussion of genetic heterogeneity of primary ciliary dyskinesia, see 244400.

Professional guidelines

PubMed

DeGeorge KC, Ring DJ, Dalrymple SN
Am Fam Physician 2019 Sep 1;100(5):281-289. PMID: 31478634
Seidman MD, Gurgel RK, Lin SY, Schwartz SR, Baroody FM, Bonner JR, Dawson DE, Dykewicz MS, Hackell JM, Han JK, Ishman SL, Krouse HJ, Malekzadeh S, Mims JW, Omole FS, Reddy WD, Wallace DV, Walsh SA, Warren BE, Wilson MN, Nnacheta LC; Guideline Otolaryngology Development Group. AAO-HNSF
Otolaryngol Head Neck Surg 2015 Feb;152(1 Suppl):S1-43. doi: 10.1177/0194599814561600. PMID: 25644617
Abuabara A
Med Oral Patol Oral Cir Bucal 2007 Sep 1;12(5):E397-400. PMID: 17767107

Recent clinical studies

Etiology

El Khoury P, Abou Hamad W, Khalaf MG, El Hadi C, Assily R, Rassi S, Khoueir N
Laryngoscope 2023 Dec;133(12):3247-3255. Epub 2023 Apr 17 doi: 10.1002/lary.30706. PMID: 37067019
Pang JC, Vasudev M, Du AT, Nottoli MM, Dang K, Kuan EC
Laryngoscope 2023 Apr;133(4):722-731. Epub 2022 Jul 15 doi: 10.1002/lary.30306. PMID: 35838014
Georgalas C, Oostra A, Ahmed S, Castelnuovo P, Dallan I, van Furth W, Harvey RJ, Herman P, Kombogiorgas D, Locatelli D, Meco C, Palmer JN, Piltcher O, Sama AM, Saleh H, Sindwani R, Van Zele T, Woodworth BA
Int Forum Allergy Rhinol 2021 Apr;11(4):794-803. Epub 2020 Oct 25 doi: 10.1002/alr.22704. PMID: 33099888
Kern RC
Int Forum Allergy Rhinol 2016 Jan;6(1):5-7. doi: 10.1002/alr.21713. PMID: 26749201
Abuabara A
Med Oral Patol Oral Cir Bucal 2007 Sep 1;12(5):E397-400. PMID: 17767107

Diagnosis

Xie M, Zhou K, Kachra S, McHugh T, Sommer DD
Am J Rhinol Allergy 2022 May;36(3):397-406. Epub 2021 Nov 30 doi: 10.1177/19458924211060918. PMID: 34846218Free PMC Article
Georgalas C, Oostra A, Ahmed S, Castelnuovo P, Dallan I, van Furth W, Harvey RJ, Herman P, Kombogiorgas D, Locatelli D, Meco C, Palmer JN, Piltcher O, Sama AM, Saleh H, Sindwani R, Van Zele T, Woodworth BA
Int Forum Allergy Rhinol 2021 Apr;11(4):794-803. Epub 2020 Oct 25 doi: 10.1002/alr.22704. PMID: 33099888
Reddy M, Baugnon K
Radiol Clin North Am 2017 Jan;55(1):167-187. doi: 10.1016/j.rcl.2016.08.005. PMID: 27890184
Kern RC
Int Forum Allergy Rhinol 2016 Jan;6(1):5-7. doi: 10.1002/alr.21713. PMID: 26749201
Abuabara A
Med Oral Patol Oral Cir Bucal 2007 Sep 1;12(5):E397-400. PMID: 17767107

Therapy

Am Fam Physician 2022 Jan 1;105(1):Online. PMID: 35029959
Yan CH, Hwang PH
Otolaryngol Clin North Am 2018 Oct;51(5):945-955. Epub 2018 Jun 22 doi: 10.1016/j.otc.2018.05.010. PMID: 29937065
Schlosser RJ
Int Forum Allergy Rhinol 2016 Nov;6(11):1111-1112. doi: 10.1002/alr.21868. PMID: 27808483
Fokkens W, Hellings P, Segboer C
Curr Allergy Asthma Rep 2016 Aug;16(8):60. doi: 10.1007/s11882-016-0638-1. PMID: 27485456Free PMC Article
Nathan CO, Seid AB
Int J Pediatr Otorhinolaryngol 1997 Feb 14;39(1):59-65. doi: 10.1016/S0165-5876(96)01464-4. PMID: 9051440

Prognosis

Ciftci Z, Catli T, Hanci D, Cingi C, Erdogan G
Eur Arch Otorhinolaryngol 2015 Oct;272(10):2587-92. Epub 2014 Jul 23 doi: 10.1007/s00405-014-3182-4. PMID: 25052947
Tomassen P, Van Zele T, Zhang N, Perez-Novo C, Van Bruaene N, Gevaert P, Bachert C
Proc Am Thorac Soc 2011 Mar;8(1):115-20. doi: 10.1513/pats.201005-036RN. PMID: 21364229
Shushan S, Sadan O, Lurie S, Evron S, Golan A, Roth Y
Am J Perinatol 2006 Oct;23(7):431-3. Epub 2006 Sep 25 doi: 10.1055/s-2006-951302. PMID: 17001552
Robinson SR, Wormald PJ
Am J Rhinol 2006 Mar-Apr;20(2):197-202. PMID: 16686388
MATSON DD
Clin Neurosurg 1964;10:116-29. doi: 10.1093/neurosurgery/10.cn_suppl_1.116. PMID: 14095868

Clinical prediction guides

Bernstein JA, Bernstein JS, Makol R, Ward S
JAMA 2024 Mar 12;331(10):866-877. doi: 10.1001/jama.2024.0530. PMID: 38470381
Pang JC, Vasudev M, Du AT, Nottoli MM, Dang K, Kuan EC
Laryngoscope 2023 Apr;133(4):722-731. Epub 2022 Jul 15 doi: 10.1002/lary.30306. PMID: 35838014
Kumar B, Scheffler P
Pediatr Ann 2021 Jul;50(7):e277-e281. Epub 2021 Jul 1 doi: 10.3928/19382359-20210613-01. PMID: 34264800
Czubak J, Stolarczyk K, Orzeł A, Frączek M, Zatoński T
Adv Clin Exp Med 2021 Jan;30(1):109-114. doi: 10.17219/acem/129573. PMID: 33529514
Bertrand B, Eloy P, Rombeaux P
Acta Otorhinolaryngol Belg 1997;51(4):227-37. PMID: 9444371

Recent systematic reviews

El Khoury P, Abou Hamad W, Khalaf MG, El Hadi C, Assily R, Rassi S, Khoueir N
Laryngoscope 2023 Dec;133(12):3247-3255. Epub 2023 Apr 17 doi: 10.1002/lary.30706. PMID: 37067019
Pang JC, Vasudev M, Du AT, Nottoli MM, Dang K, Kuan EC
Laryngoscope 2023 Apr;133(4):722-731. Epub 2022 Jul 15 doi: 10.1002/lary.30306. PMID: 35838014
Liu N, Yang D, Zhang T, Sun J, Fu J, Li H
Int J Infect Dis 2022 Apr;117:155-161. Epub 2022 Feb 5 doi: 10.1016/j.ijid.2022.02.004. PMID: 35134561Free PMC Article
Xie M, Zhou K, Kachra S, McHugh T, Sommer DD
Am J Rhinol Allergy 2022 May;36(3):397-406. Epub 2021 Nov 30 doi: 10.1177/19458924211060918. PMID: 34846218Free PMC Article
Czubak J, Stolarczyk K, Orzeł A, Frączek M, Zatoński T
Adv Clin Exp Med 2021 Jan;30(1):109-114. doi: 10.17219/acem/129573. PMID: 33529514

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