engleski

Severe rhinitis

Severity of rhinitis is determined primarily according to the impact of rhinitis symptoms on health-related quality of life. The classification according to one of the mostly accepted international guidelines defines allergic rhinitis as moderate or severe if only one of the categories of quality of life, like sleep or work is affected by the disease. However, using that classification, almost 90% of the patients fall in the category of moderate to severe. Measurement of symptoms severity on the visual analog scale seems more appropriate in staging the severity of rhinitis than simple scoring into 3 grades of severity. However, one must bear in mind that there is an uneven distribution of the perception of severity on visual analog scale, and staging of severity should be based using the Rasch model. According to the literature, many of the objective parameters of inflammation are correlated with the severity of rhinitis, but correlation coefficients do not suggest that inflammation is the only parameter that has impact on the severity of the disease. While allergic rhinitis may be put into 2 major phenotypes, intermittent and persistent, based on duration of symptoms, or perennial and seasonal, based on the etiology, non-allergic rhinitis is more heterogeneous disease, where more factors, like neural regulation, including cholinergic reflexes, ion channel receptors abnormality, inflammation with cellular influx, hyperreactivity with different level of environmental triggers, may play a role. It is clear that symptom scores and the impact on health related quality of life is also influenced by upper and lower airways comorbidities, like rhinosinusitis, nasal polyps or asthma.

Rhinitis; symptoms; classification; allergic rhinitis

nije evidentirano