clinical features

Last edited 02/2022 and last reviewed 04/2023

Allergic rhinitis is characterised by rhinorrhoea, nasal blockage and sneezing attacks for longer than 1 hour per day lasting for 2 weeks.

More detailed information concerning clinical features is presented below:

  • nasal blockage—intermittent, alternating unilateral blockage—a persistent unilateral blockage may indicate a mechanical cause e.g., septum deviation, nasal polyp
  • sneezing—often paroxysmal (1)
  • nasal itching
  • rhinorrhoea—can be anterior resulting in persistent sniffing and nose-blowing, or posterior resulting in postnasal drip; if there is unilateral rhinorrhoea in an adult, this should alert the clinician to the possibility of cerebrospinal fluid
  • unilateral rhinorrhoea in a child may be secondary to a foreign body
  • epiphora, reddening of conjunctivae, swelling of eyelids
  • reduced taste or smell
  • headaches—often without sinusitis; the pain may be referred to the forehead, lateral to nose, around the eye or over the cheeks
  • reduced hearing due to eustachian tube dysfunction

Signs may include:

  • oedematous nasal mucosa, often blue
  • clear nasal discharge
  • nasal crease or nasal salute, especially in children

Reference:

  1. Eifan AO, Durham SR. Pathogenesis of rhinitis. Clin Exp Allergy. 2016;46(9):1139–51.