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Review
. 2023 Oct 30;65(1):e1-e11.
doi: 10.4102/safp.v65i1.5806.

Allergic rhinitis: Review of the diagnosis and management: South African Allergic Rhinitis Working Group

Guy A Richards  1 , Marinda McDonald, Claudia L Gray, Pieter De Waal, Ray Friedman, Maurice Hockman, Sarah J Karabus, Cornelia M Lodder, Tshegofatso Mabelane, Sylvia M Mosito, Ashen Nanan, Jonny G Peter, Traugott H C Quitter, Riaz Seedat, Sylvia Van den Berg, Andre Van Niekerk, Eftyhia Vardas, Charles Feldman
Affiliations
Review

Allergic rhinitis: Review of the diagnosis and management: South African Allergic Rhinitis Working Group

Guy A Richards et al. S Afr Fam Pract (2004). .

Erratum in

Abstract

Background: Allergic rhinitis (AR) has a significant impact on the community as a whole with regard to quality of life and its relationship to allergic multi-morbidities. Appropriate diagnosis, treatment and review of the efficacy of interventions can ameliorate these effects. Yet, the importance of AR is often overlooked, and appropriate therapy is neglected. The availability of effective medications and knowledge as to management are often lacking in both public and private health systems.

Methods: This review is based on a comprehensive literature search and detailed discussions by the South African Allergic Rhinitis Working Group (SAARWG).

Results: The working group provided up-to-date recommendations on the epidemiology, pathology, diagnosis and management of AR, appropriate to the South African setting.

Conclusion: Allergic rhinitis causes significant, often unappreciated, morbidity. It is a complex disease related to an inflammatory response to environmental allergens. Therapy involves education, evaluation of allergen sensitisation, pharmacological treatment, allergen immunotherapy (AIT) and evaluation of the success of interventions. Regular use of saline; the important role of intranasal corticosteroids, including those combined with topical antihistamines and reduction in the use of systemic steroids are key. Practitioners should have a thorough knowledge of associated morbidities and the need for specialist referral.Contribution: This review summarises the latest developments in the diagnosis and management of AR such that it is a resource that allows easy access for family practitioners and specialists alike.

Keywords: allergic rhinitis; antihistamines; immunotherapy; intranasal corticosteroids; saline rinse.

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Conflict of interest statement

C.F. has received speakers fees from Aspen, MSD, Astra Zeneca, Aurogen, Procter and Gamble. G.A.R. has received speakers fees from Glenmark, Aspen, MSD, Astra Zeneca, Novartis, Cipla, Acino, Sandoz, and consultative fees from Cipla. C.M.L. has received speakers fees from Glenmark, Astra Zeneca, Norvartis, Cipla, Acino, Sandoz, and consultative fees from Cipla. R.F. has received speakers fees from Aspen and Glenmark. M.H. has received speakers fees from GSK, Aspen, Pharmacare, Glenmark, Medel and SouthernENT. J.P. has received support for pollen monitoring across South Africa from Novartis, Glenmark, Clicks, Pharmadynamics, Dr Reddy’s, Thermofischer Scientific, Twinsaver and A Vogel Echinaforce and speakers fees from Glenmark, Johnson and Johnson, Sanofi and Astra Zeneca. T.M. has received speakers fees from Aspen, Astra Zeneca and Cipla. A.v.N. has received speakers fees from Acino, Actor Pharma, Aspen, Astra Zeneca and Glenmark, MSD, Organon, Sanofi and Takeda. C.L.G. has received speaker’s fees from Aspen, Astra Zeneca, Cipla, Glenmark and Organon. M.M. has received speakers fees from Glenmark, Cipla, Aspen, Sanofi, Proctor and Gamble, Thermo Scientific, Lancet laboratories and Immunospec. A.N., P.d.W., S.K., R.S., S.v.d.B., C.Q., S.M. and E.V. have no disclosures.

Figures

FIGURE 1
FIGURE 1
Allergic Rhinitis and Its Impact on Asthma guidelines on allergic rhinitis categorisation in untreated patients.
FIGURE 2
FIGURE 2
First-line testing recommendations to either rule out allergic rhinitis or guide first-line treatments or allergen avoidance strategies in allergic rhinitis.
FIGURE 3
FIGURE 3
Technique for using nasal sprays. (a) Correct technique, (b) direction of spray using correct technique and (c) incorrect technique.
FIGURE 4
FIGURE 4
Flow diagram describing Management of Allergic Rhinitis.
See this image and copyright information in PMC

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