[Non-allergic chronic rhinitis]

Abstract

Objective: To review the existent literature regarding non-allergic rhinitis.

Data sources: PubMed search was performed using the key words: non-allergic rhinitis, vasomotor rhinitis, irritant rhinitis, idiopathic rhinitis, chronic rhinopathy, nociceptive dysfunction, capsaicin, entopy.

Study selection: Articles were selected based on their relevance to this review.

Results: Chronic rhinitis affects up to 20% of the general population. The term rhinitis (inflammation of the nasal mucosal membrane) is used in daily practice for nasal dysfunction causing symptoms like nasal itching, sneezing, rhinorrhea, and or nasal blockage. When allergy, mechanical obstruction, and infections have been excluded as the cause of rhinitis, a number of poorly defined nasal conditions of partly unknown etiology and pathophysiology remain. The differential diagnosis of non-allergic noninfectious rhinitis is extensive. If the pathophysiology is unknown, the term idiopathic rhinitis is used as well as vasomotor rhinitis. This term has been recently questioned and the term non-allergic rhinopathy has been proposed with the subsequent definition and inclusion criteria delineated; other forms include irritative-toxic (occupational) rhinitis, hormonal rhinitis, drug-induced rhinitis, non-allergic rhinitis with eosinophilia syndrome, rhinitis due to physical and chemical factors, food-induced rhinitis, emotion-induced rhinitis, atrophic rhinitis.

Conclusions: The number of patients with non-allergic, non-infectious rhinitis as a known cause or precipitant factor has increased in the last years. Nevertheless, 50% of the patients have to be classified as non-allergic rhinitis, known today as non-allergic rhinopathy. It's important for this group of patients to be evaluated by an expert in Rhinology and Allergy to determine the best possible treatment.