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Allergic rhinitis

MedGen UID:
Concept ID:
Disease or Syndrome
Synonyms: Allergic Rhinitides; Allergic Rhinitis; Rhinitides, Allergic; Rhinitis, Allergic
SNOMED CT: Allergic rhinitis (61582004); AR - Allergic rhinitis (61582004); Atopic rhinitis (61582004); Allergic rhinitis due to allergen (61582004)
HPO: HP:0003193
Monarch Initiative: MONDO:0011786
OMIM®: 607154


It is characterized by one or more symptoms including sneezing, itching, nasal congestion, and rhinorrhea. [from HPO]

Conditions with this feature

Anaphylotoxin inactivator deficiency
MedGen UID:
Concept ID:
Disease or Syndrome
An autosomal recessive condition caused by mutation(s) in the CPN1 gene, encoding carboxypeptidase N catalytic chain. It may be characterized by episodic angioedema, chronic urticaria, asthma and/or allergic hypersensitivity.
Progeroid short stature with pigmented nevi
MedGen UID:
Concept ID:
Disease or Syndrome
Mulvihill-Smith syndrome is characterized by premature aging, multiple pigmented nevi, lack of facial subcutaneous fat, microcephaly, short stature, sensorineural hearing loss, and mental retardation. Immunodeficiency may also be a feature. Adult manifestations include the development of tumors, a sleep disorder with severe insomnia, and cognitive decline (summary by Yagihashi et al., 2009).
Ichthyosis prematurity syndrome
MedGen UID:
Concept ID:
Disease or Syndrome
Autosomal recessive congenital ichthyosis (ARCI) encompasses several forms of nonsyndromic ichthyosis. Although most neonates with ARCI are collodion babies, the clinical presentation and severity of ARCI may vary significantly, ranging from harlequin ichthyosis, the most severe and often fatal form, to lamellar ichthyosis (LI) and (nonbullous) congenital ichthyosiform erythroderma (CIE). These phenotypes are now recognized to fall on a continuum; however, the phenotypic descriptions are clinically useful for clarification of prognosis and management. Infants with harlequin ichthyosis are usually born prematurely and are encased in thick, hard, armor-like plates of cornified skin that severely restrict movement. Life-threatening complications in the immediate postnatal period include respiratory distress, feeding problems, and systemic infection. Collodion babies are born with a taut, shiny, translucent or opaque membrane that encases the entire body and lasts for days to weeks. LI and CIE are seemingly distinct phenotypes: classic, severe LI with dark brown, plate-like scale with no erythroderma and CIE with finer whiter scale and underlying generalized redness of the skin. Affected individuals with severe involvement can have ectropion, eclabium, scarring alopecia involving the scalp and eyebrows, and palmar and plantar keratoderma. Besides these major forms of nonsyndromic ichthyosis, a few rare subtypes have been recognized, such as bathing suit ichthyosis, self-improving collodion ichthyosis, or ichthyosis-prematurity syndrome.
IgE responsiveness, atopic
MedGen UID:
Concept ID:
Disease or Syndrome
Atopy is an allergic disorder characterized by immunoglobulin E (IgE) responses to environmental proteins that are otherwise innocuous and predominantly found in plant pollen and house dust. It is the major cause of asthma (see 600807), rhinitis (see 607154), and eczema (see 603165) in children and young adults (summary by Young et al., 1992).
MedGen UID:
Concept ID:
Disease or Syndrome
Abnormally low level of eosinophils in the blood.
Dermatitis, atopic
MedGen UID:
Concept ID:
Disease or Syndrome
Pancreatic insufficiency-anemia-hyperostosis syndrome
MedGen UID:
Concept ID:
Disease or Syndrome
This syndrome is characterized by exocrine pancreatic insufficiency, dyserythropoietic anemia, and calvarial hyperostosis. It has been described in four children, three boys and one girl, from two consanguineous families. The disease is due to a mutation in the COX4I2 gene, encoding a mitochondrial cytochrome C oxidase sub-unit. Transmission is autosomal recessive.
Familial cold autoinflammatory syndrome 3
MedGen UID:
Concept ID:
Disease or Syndrome
Familial cold autoinflammatory syndrome-3 is an autosomal dominant immune disorder characterized by the development of cutaneous urticaria, erythema, and pruritus in response to cold exposure. Affected individuals have variable additional immunologic defects, including antibody deficiency, decreased numbers of B cells, defective B cells, increased susceptibility to infection, and increased risk of autoimmune disorders (summary by Ombrello et al., 2012). For a discussion of genetic heterogeneity of FCAS, see FCAS1 (120100).
Immunodeficiency 23
MedGen UID:
Concept ID:
Disease or Syndrome
IMD23 is an autosomal recessive primary immunodeficiency syndrome characterized by onset of recurrent infections, usually respiratory or cutaneous, in early childhood. Immune workup usually shows neutropenia, lymphopenia, eosinophilia, and increased serum IgE or IgA. Neutrophil chemotactic defects have also been reported. Infectious agents include bacteria, viruses, and fungi. Many patients develop atopic dermatitis, eczema, and other signs of autoinflammation. Affected individuals may also show developmental delay or cognitive impairment of varying severity (summary by Bjorksten and Lundmark, 1976 and Zhang et al., 2014).
Combined immunodeficiency due to DOCK8 deficiency
MedGen UID:
Concept ID:
Disease or Syndrome
Hyper-IgE syndrome-2 with recurrent infections (HIES2) is an autosomal recessive immunologic disorder characterized by recurrent staphylococcal infections of the skin and respiratory tract, eczema, elevated serum immunoglobulin E, and hypereosinophilia. It is distinguished from autosomal dominant HIES1 (147060) by the lack of connective tissue and skeletal involvement (Renner et al., 2004). For a discussion of genetic heterogeneity of hyper-IgE syndrome, see 147060. See also TYK2 deficiency (611521), a clinically distinct disease entity that includes characteristic features of both autosomal recessive HIES2 and mendelian susceptibility to mycobacterial disease (MSMD; 209950) (Minegishi et al., 2006).
Severe combined immunodeficiency due to CARMIL2 deficiency
MedGen UID:
Concept ID:
Disease or Syndrome
Immunodeficiency-58 is an autosomal recessive primary immunologic disorder characterized by early-onset skin lesions, including eczematous dermatitis, infectious abscesses, and warts, recurrent respiratory infections or allergies, and chronic persistent infections with candida, Molluscum contagiosum, mycobacteria, EBV, bacteria, and viruses. Some patients may have gastrointestinal involvement, including inflammatory bowel disease, EBV+ smooth muscle tumors, and esophagitis. Immunologic analysis shows defective T-cell function with decreased Treg cells and deficient CD3/CD28 costimulation responses in both CD4+ and CD8+ T cells. B-cell function may also be impaired (summary by Wang et al., 2016 and Alazami et al., 2018).
Spondyloepimetaphyseal dysplasia, Krakow type
MedGen UID:
Concept ID:
Disease or Syndrome
Krakow-type spondyloepimetaphyseal dysplasia is characterized by severe skeletal dysplasia, severe immunodeficiency, and developmental delay (Csukasi et al., 2018).
Netherton syndrome
MedGen UID:
Concept ID:
Disease or Syndrome
Netherton syndrome (NETH) is a rare and severe autosomal recessive skin disorder characterized by congenital erythroderma, a specific hair-shaft abnormality, and atopic manifestations with high IgE levels. Generalized scaly erythroderma is apparent at or soon after birth and usually persists. Scalp hair is sparse and brittle with a characteristic 'bamboo' shape under light microscopic examination due to invagination of the distal part of the hair shaft to its proximal part. Atopic manifestations include eczema-like rashes, atopic dermatitis, pruritus, hay fever, angioedema, urticaria, high levels of IgE in the serum, and hypereosinophilia. Life-threatening complications are frequent during the neonatal period, including hypernatremic dehydration, hypothermia, extreme weight loss, bronchopneumonia, and sepsis. During childhood, failure to thrive is common as a result of malnutrition, metabolic disorders, chronic erythroderma, persistent cutaneous infections, or enteropathy (summary by Bitoun et al., 2002).

Professional guidelines


Wise SK, Damask C, Roland LT, Ebert C, Levy JM, Lin S, Luong A, Rodriguez K, Sedaghat AR, Toskala E, Villwock J, Abdullah B, Akdis C, Alt JA, Ansotegui IJ, Azar A, Baroody F, Benninger MS, Bernstein J, Brook C, Campbell R, Casale T, Chaaban MR, Chew FT, Chambliss J, Cianferoni A, Custovic A, Davis EM, DelGaudio JM, Ellis AK, Flanagan C, Fokkens WJ, Franzese C, Greenhawt M, Gill A, Halderman A, Hohlfeld JM, Incorvaia C, Joe SA, Joshi S, Kuruvilla ME, Kim J, Klein AM, Krouse HJ, Kuan EC, Lang D, Larenas-Linnemann D, Laury AM, Lechner M, Lee SE, Lee VS, Loftus P, Marcus S, Marzouk H, Mattos J, McCoul E, Melen E, Mims JW, Mullol J, Nayak JV, Oppenheimer J, Orlandi RR, Phillips K, Platt M, Ramanathan M Jr, Raymond M, Rhee CS, Reitsma S, Ryan M, Sastre J, Schlosser RJ, Schuman TA, Shaker MS, Sheikh A, Smith KA, Soyka MB, Takashima M, Tang M, Tantilipikorn P, Taw MB, Tversky J, Tyler MA, Veling MC, Wallace D, Wang Y, White A, Zhang L
Int Forum Allergy Rhinol 2023 Apr;13(4):293-859. Epub 2023 Mar 6 doi: 10.1002/alr.23090. PMID: 36878860
Siddiqui ZA, Walker A, Pirwani MM, Tahiri M, Syed I
Br J Hosp Med (Lond) 2022 Feb 2;83(2):1-9. Epub 2022 Feb 23 doi: 10.12968/hmed.2021.0570. PMID: 35243888
Dykewicz MS, Wallace DV, Amrol DJ, Baroody FM, Bernstein JA, Craig TJ, Dinakar C, Ellis AK, Finegold I, Golden DBK, Greenhawt MJ, Hagan JB, Horner CC, Khan DA, Lang DM, Larenas-Linnemann DES, Lieberman JA, Meltzer EO, Oppenheimer JJ, Rank MA, Shaker MS, Shaw JL, Steven GC, Stukus DR, Wang J; Chief Editor(s):, Dykewicz MS, Wallace DV; Joint Task Force on Practice Parameters:, Dinakar C, Ellis AK, Golden DBK, Greenhawt MJ, Horner CC, Khan DA, Lang DM, Lieberman JA, Oppenheimer JJ, Rank MA, Shaker MS, Stukus DR, Wang J; Workgroup Contributors:, Dykewicz MS, Wallace DV, Amrol DJ, Baroody FM, Bernstein JA, Craig TJ, Finegold I, Hagan JB, Larenas-Linnemann DES, Meltzer EO, Shaw JL, Steven GC
J Allergy Clin Immunol 2020 Oct;146(4):721-767. Epub 2020 Jul 22 doi: 10.1016/j.jaci.2020.07.007. PMID: 32707227

Recent clinical studies


Nappi E, Paoletti G, Malvezzi L, Ferri S, Racca F, Messina MR, Puggioni F, Heffler E, Canonica GW
Expert Rev Clin Immunol 2022 Jul;18(7):747-758. Epub 2022 Jun 19 doi: 10.1080/1744666X.2022.2089654. PMID: 35695326
Choi BY, Han M, Kwak JW, Kim TH
Genes (Basel) 2021 Dec 17;12(12) doi: 10.3390/genes12122004. PMID: 34946955Free PMC Article
Chirakalwasan N, Ruxrungtham K
Asian Pac J Allergy Immunol 2014 Dec;32(4):276-86. PMID: 25543037
Greiner AN, Hellings PW, Rotiroti G, Scadding GK
Lancet 2011 Dec 17;378(9809):2112-22. Epub 2011 Jul 23 doi: 10.1016/S0140-6736(11)60130-X. PMID: 21783242
Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, Zuberbier T, Baena-Cagnani CE, Canonica GW, van Weel C, Agache I, Aït-Khaled N, Bachert C, Blaiss MS, Bonini S, Boulet LP, Bousquet PJ, Camargos P, Carlsen KH, Chen Y, Custovic A, Dahl R, Demoly P, Douagui H, Durham SR, van Wijk RG, Kalayci O, Kaliner MA, Kim YY, Kowalski ML, Kuna P, Le LT, Lemiere C, Li J, Lockey RF, Mavale-Manuel S, Meltzer EO, Mohammad Y, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Ouedraogo S, Palkonen S, Papadopoulos N, Passalacqua G, Pawankar R, Popov TA, Rabe KF, Rosado-Pinto J, Scadding GK, Simons FE, Toskala E, Valovirta E, van Cauwenberge P, Wang DY, Wickman M, Yawn BP, Yorgancioglu A, Yusuf OM, Zar H, Annesi-Maesano I, Bateman ED, Ben Kheder A, Boakye DA, Bouchard J, Burney P, Busse WW, Chan-Yeung M, Chavannes NH, Chuchalin A, Dolen WK, Emuzyte R, Grouse L, Humbert M, Jackson C, Johnston SL, Keith PK, Kemp JP, Klossek JM, Larenas-Linnemann D, Lipworth B, Malo JL, Marshall GD, Naspitz C, Nekam K, Niggemann B, Nizankowska-Mogilnicka E, Okamoto Y, Orru MP, Potter P, Price D, Stoloff SW, Vandenplas O, Viegi G, Williams D; World Health Organization; GA(2)LEN; AllerGen
Allergy 2008 Apr;63 Suppl 86:8-160. doi: 10.1111/j.1398-9995.2007.01620.x. PMID: 18331513


Siddiqui ZA, Walker A, Pirwani MM, Tahiri M, Syed I
Br J Hosp Med (Lond) 2022 Feb 2;83(2):1-9. Epub 2022 Feb 23 doi: 10.12968/hmed.2021.0570. PMID: 35243888
Okubo K, Kurono Y, Ichimura K, Enomoto T, Okamoto Y, Kawauchi H, Suzaki H, Fujieda S, Masuyama K; Japanese Society of Allergology
Allergol Int 2020 Jul;69(3):331-345. Epub 2020 May 27 doi: 10.1016/j.alit.2020.04.001. PMID: 32473790
Hoyte FCL, Nelson HS
F1000Res 2018;7 Epub 2018 Aug 23 doi: 10.12688/f1000research.15367.1. PMID: 30210782Free PMC Article
Beard S
Prim Care 2014 Mar;41(1):33-46. Epub 2013 Nov 28 doi: 10.1016/j.pop.2013.10.005. PMID: 24439879Free PMC Article
Greiner AN, Hellings PW, Rotiroti G, Scadding GK
Lancet 2011 Dec 17;378(9809):2112-22. Epub 2011 Jul 23 doi: 10.1016/S0140-6736(11)60130-X. PMID: 21783242


Hong D, Weng J, Ye M, Liu Y
Braz J Otorhinolaryngol 2023 Jul-Aug;89(4):101272. Epub 2023 Apr 7 doi: 10.1016/j.bjorl.2023.03.009. PMID: 37271114Free PMC Article
Nelson HS
Allergy Asthma Proc 2022 Nov 1;43(6):501-508. doi: 10.2500/aap.2022.43.220053. PMID: 36335411
Virtanen T
Hum Vaccin Immunother 2018 Apr 3;14(4):807-814. Epub 2017 Dec 21 doi: 10.1080/21645515.2017.1409315. PMID: 29182437Free PMC Article
West CE
Benef Microbes 2016;7(2):171-9. Epub 2015 Dec 21 doi: 10.3920/BM2015.0073. PMID: 26689229
Church MK
Expert Opin Drug Saf 2011 Sep;10(5):779-93. Epub 2011 Aug 11 doi: 10.1517/14740338.2011.604029. PMID: 21831011


Lapi F, Cassano N, Barbieri E, Marconi E, Vena GA, Giaquinto C, Cricelli C
Curr Med Res Opin 2023 Sep;39(9):1257-1262. Epub 2023 Aug 10 doi: 10.1080/03007995.2023.2243216. PMID: 37526047
Nocerino R, Bedogni G, Carucci L, Cosenza L, Cozzolino T, Paparo L, Palazzo S, Riva L, Verduci E, Berni Canani R
J Pediatr 2021 May;232:183-191.e3. Epub 2021 Jan 29 doi: 10.1016/j.jpeds.2021.01.059. PMID: 33524387
Lyons-Weiler J, Thomas P
Int J Environ Res Public Health 2020 Nov 22;17(22) doi: 10.3390/ijerph17228674. PMID: 33266457Free PMC Article
Jung SY, Park DC, Kim SH, Yeo SG
Curr Allergy Asthma Rep 2019 Jun 3;19(7):34. doi: 10.1007/s11882-019-0865-3. PMID: 31161431
Strachan DP
BMJ 1989 Nov 18;299(6710):1259-60. doi: 10.1136/bmj.299.6710.1259. PMID: 2513902Free PMC Article

Clinical prediction guides

Marko M, Pawliczak R
Expert Rev Respir Med 2023 Jul-Dec;17(7):607-621. Epub 2023 Jul 28 doi: 10.1080/17476348.2023.2241364. PMID: 37489655
Schröder J, Mösges R
Curr Opin Allergy Clin Immunol 2018 Oct;18(5):393-397. doi: 10.1097/ACI.0000000000000470. PMID: 30020256
Gelardi M, Leo ME, Quaranta VN, Iannuzzi L, Tripodi S, Quaranta N, Canonica GW, Passalacqua G
J Allergy Clin Immunol Pract 2015 May-Jun;3(3):387-91.e1. Epub 2015 Jan 26 doi: 10.1016/j.jaip.2015.01.006. PMID: 25634218
Calderon MA, Bernstein DI, Blaiss M, Andersen JS, Nolte H
Clin Exp Allergy 2014 Oct;44(10):1228-39. doi: 10.1111/cea.12331. PMID: 24773171
Davis BE, Cockcroft DW
Expert Rev Respir Med 2012 Jun;6(3):321-9. doi: 10.1586/ers.12.29. PMID: 22788946

Recent systematic reviews

Mayoral K, Lizano-Barrantes C, Zamora V, Pont A, Miret C, Barrufet C, Caballero-Rabasco MA, Praena-Crespo M, Bercedo A, Valdesoiro-Navarrete L, Guerra MT, Pardo Y, Martínez Zapata MJ, Garin O, Ferrer M; ARCA Group
Eur Respir Rev 2023 Dec 31;32(170) Epub 2023 Oct 18 doi: 10.1183/16000617.0124-2023. PMID: 37852659Free PMC Article
Licari A, Magri P, De Silvestri A, Giannetti A, Indolfi C, Mori F, Marseglia GL, Peroni D
J Allergy Clin Immunol Pract 2023 Aug;11(8):2547-2556. Epub 2023 May 24 doi: 10.1016/j.jaip.2023.05.016. PMID: 37236349
He M, Qin W, Qin Z, Zhao C
Eur J Med Res 2022 Apr 25;27(1):58. doi: 10.1186/s40001-022-00682-3. PMID: 35462555Free PMC Article
Obbagy JE, English LK, Wong YP, Butte NF, Dewey KG, Fleischer DM, Fox MK, Greer FR, Krebs NF, Scanlon KS, Stoody EE
Am J Clin Nutr 2019 Mar 1;109(Suppl_7):890S-934S. doi: 10.1093/ajcn/nqy220. PMID: 30982864
Head K, Snidvongs K, Glew S, Scadding G, Schilder AG, Philpott C, Hopkins C
Cochrane Database Syst Rev 2018 Jun 22;6(6):CD012597. doi: 10.1002/14651858.CD012597.pub2. PMID: 29932206Free PMC Article

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