Hay fever or allergic rhinitis is an allergic inflammation of the nasal membranes that is characterized by rhinorrhea, sneezing, nasal congestion and pruritus.
Presentation
The main symptoms of allergic rhinitis are rhinorrhea (increase in nasal secretion), pruritus, sneezing fits, obstruction and congestion of the nasal pathway [7]. Other characteristic physical findings include conjuctival swelling and erythema, eyelid swelling, lower eyelid venous stasis and effusion from the middle ear.
Entire Body System
- Fever
I suffer from hay fever and, as a result, am asthmatic. It did not matter if someone had terrible hay fever that affected their performance or what issues they had brought from home. [dictionary.cambridge.org]
Hay Fever Hay Fever These allergies are caused by: pollen, pet dander, dust particles, and mold spores. [pollen.com]
Although symptoms resembling a cold or flu can be produced following hay fever, it doesn’t bring about a fever. [symptoma.com]
Antihistamines have been used to manage hay fever for decades and can be the first-line treatment for those with mild or occasional hay fever. [theconversation.com]
Hay Fever Treatment Hay fever does not always require medical treatment. Hay Fever Self-Care at Home Avoid known or suspected allergens. Hay fever symptoms lend themselves to home treatment. [emedicinehealth.com]
- Pain
Sinus Pain 7. Cough/wheeze 8. Exhaustion 9. Puffy and watery eyes 10. Reduced taste and smell 11. Reduced hearing 12. Itch along roof of mouth 13. Extreme exhaustion 14. [dailymail.co.uk]
This was accompanied by painful anterior cervical lymphadenopathy. The condition responded well to an oral cephalosporin and increased fluid intake along with an analgesic agent. The patient recovered without sequelae. [ncbi.nlm.nih.gov]
Hay fever sufferers also don’t experience fevers or body aches and pains. Is it possible to have a cold and hay fever at the same time? Unfortunately, it’s possible to suffer from both a cold and hay fever at the same time. [healthpartners.com.au]
Learn More About Topic Sinus headaches is a common term used by patients and some healthcare providers to describe pain or pressure in the face, over the forehead, or between or behind the eyes. [entnet.org]
- Fatigue
Symptoms include itchy eyes, runny nose, sneezing, and fatigue. These symptoms can be accompanied by cough and wheezing. The name “Hay fever” originates from symptoms that occur during the time of year when farmers harvest and bale hay. [pmaonline.com]
It may lead to fatigue, drowsiness, and malaise thus causing impairment of the quality of life. [icd9data.com]
Prolonged, sometime violent sneezing Itchy, painful nose, throat, and roof of mouth-breathing Stuffy, runny nose Postnasal drip, resulting in coughing Watery, itchy eyes Head and nasal congestion Ear pressure or fullness Fatigue Hay fever symptoms could [ohioallergyclinic.com]
However, common signs of hay fever include: • Nasal congestion • Cough • Postnasal Drip • Fatigue • Sneezing How is hay fever diagnosed? If you think you may be suffering from hay fever, contact an allergist. [carolinaasthma.com]
The usual symptoms of hay fever include the following: Sneezing Runny nose (clear, thin discharge) Congested ("stuffy") nose Postnasal drip Sensation of plugged ear(s) Watery, bloodshot eyes Itching of nose, soft palate, ear canal, eyes, and/or skin Fatigue [emedicinehealth.com]
- Weakness
CONCLUSIONS: The IgE response against grass pollen molecules can start years before disease onset as a weak monosensitization or oligosensitization phenomenon. [ncbi.nlm.nih.gov]
Symptoms include fever, weakness, fatigue, cough, congestion and postnasal drip. What's the difference between a cold and sinusitis? It can be very hard to distinguish a bad cold from sinusitis. [wexnermedical.osu.edu]
When used long-term at high doses, oral corticosteroids can cause many side effects, including weight gain, high blood pressure, diabetes, brittle bones, thinning skin, muscle weakness, and cataracts. [web.archive.org]
- Weight Loss
She focused her master of healthcare leadership research project on health coaching for long-term weight loss in obese adults. [ausmed.com]
First, in humans and animals, activation of the immune system causes sickness behaviors that present during a major depressive episode (MDE), such as low mood, anhedonia, anorexia, and weight loss. [archpsyc.jamanetwork.com]
Respiratoric
- Sneezing
“It’s like a grenade going off in your nose; within 30 seconds you’re sneezing” Advertisement In most people, these harmless proteins are ignored, but those with allergies are not so lucky. [newscientist.com]
Conjunctival infection and edema of the nasal mucosa lead to attacks of sneezing. [britannica.com]
General allergy symptoms include: sneezing clear, watery nasal discharge and congestion itchy eyes, nose, and throat watery eyes [pollen.com]
Hay fever or allergic rhinitis is an allergic inflammation of the nasal membranes that is characterized by rhinorrhea, sneezing, nasal congestion and pruritus. [symptoma.com]
RESULTS: Significant reductions in severity of symptom scores were found for sneezing, running nose, running eyes and itchy mouth/palate (p < or = 0.05). [ncbi.nlm.nih.gov]
- Rhinitis
Taking into account the airborne allergens listed above, there are two forms of allergic rhinitis: Seasonal Allergic Rhinitis (also called Hay Fever or Pollinosis) and Perennial Allergic Rhinitis. [pollen.com]
Pollens of insect pollinated plants cannot cause allergic rhinitis because they are not able to remain airborne for long and do not carry any risks. Below are some plants that have been implicated as etiologic factors for allergic rhinitis. [symptoma.com]
Overview Symptoms & Diagnosis Treatment & Management Rhinitis (HaY fever) Overview There are two types of rhinitis: allergic and non-allergic. [aaaai.org]
Perennial/diagnosis Rhinitis, Allergic, Seasonal/complications* Rhinitis, Allergic, Seasonal/diagnosis Risk Factors Sweden/epidemiology [ncbi.nlm.nih.gov]
- Cough
Cough/wheeze 8. Exhaustion 9. Puffy and watery eyes 10. Reduced taste and smell 11. Reduced hearing 12. Itch along roof of mouth 13. Extreme exhaustion 14. [dailymail.co.uk]
Indicators of home dampness were strongly and significantly associated with dry cough, wheeze, and rhinitis symptoms. [ncbi.nlm.nih.gov]
Symptoms of cough and wheezing are more concerning and should be addressed by a doctor. Patients whose symptoms are not relieved by medications may benefit from allergen immunotherapy or “allergy shots”. [pmaonline.com]
How you tell the difference Both hay fever and the common cold causes sneezing, runny or stuffy nose and coughing. [theconversation.com]
- Nasal Congestion
congestion) Mixed rhinitis Non-allergic nasal rhinitis with eosinophilia Nonallergic rhinitis Non-allergic rhinitis Nonallergic rhinitis with eosinophilia Purulent rhinitis Rhinitis Rhinitis (nasal congestion) Rhinitis (nasal congestion), chronic Rhinitis [icd9data.com]
If nasal congestion is a major problem, decongestant pills or sprays can be used, but the nasal decongestant sprays should not be used for more than four days unless they are used in conjunction with a nasal corticosteroid spray. [aaaai.org]
It is characterised by cold-like symptoms that may include a runny nose, itchy eyes, sneezing and nasal congestion or blockage. [ncbi.nlm.nih.gov]
- Sore Throat
Hay fever can cause runny noses, streaming eyes and sore throats. Sadly, many treatments for this distressing condition are not recommended during pregnancy because of fears surrounding the effect on the unborn child. [ncbi.nlm.nih.gov]
A sore throat, on the other hand, is generally a precursor to cold. If you have cold-like symptoms and a sore throat or have had one in the last few days, your condition is more likely to be the common cold. [theconversation.com]
Stinging eyes, severe sniffles and sore throats are plaguing the poor hay fever sufferers of the UK this summer Credit: Media for Medical / Contributor/gettyimages.com L ast week's heatwave may have relented, but there's no respite for the UK's itchy-eyed [telegraph.co.uk]
These options can also reduce postnasal drip, which contributes to sore throats. [healthline.com]
Gargle with warm salt water, 1-2 tablespoons of table salt in 8 ounces of warm water, to soothe a mildly sore throat. [emedicinehealth.com]
Gastrointestinal
- Abdominal Pain
"We have a lot of people who come in with nonspecific abdominal pain, diarrhea, cramps or incapacitating gastrointestinal problems," Tobin says. [web.archive.org]
“These could include swelling, breathing difficulties, itchy skin or skin rashes and abdominal pain, amongst others. [express.co.uk]
- Nausea
Symptoms include: Stuffy or running nose Frequent sneezing Itchy eyes, nose, roof of mouth, or throat Coughing Watery eyes Blocked nose Pressure in the nose and cheeks Ear fullness and popping Dizziness and/or nausea Dark circles under the eyes Headache [southerncross.co.nz]
Known disadvantages of the use of current non‐sedating second‐generation antihistamines include the side effects of mild drowsiness, fatigue, headache, nausea and dry mouth ( Rossi 2004 ). [doi.org]
Cardiovascular
- Hypertension
PURPOSE: Hypertension is associated with inflammation. Whether the inflammation caused by allergic diseases such as allergic rhinitis can predispose to hypertension is controversial. [ncbi.nlm.nih.gov]
Musculoskeletal
- Arthritis
But while experts don’t recommend Pavlovic’s idea, stinging nettle-based supplements have been linked with everything from arthritis treatments to hair loss. [mirror.co.uk]
CBD Oil and Parkinson’s Disease Exercises that Ease Arthritis Proving Painsomnia is Real: A Case Study Acute Flaccid Myelitis Causes and Diagnosis Antibodies and Huntington's: Diagnosis & Treatment Advertisement Latest News New understanding could help [news-medical.net]
Some of the more common autoimmune diseases include type 1 diabetes, rheumatoid arthritis, systemic lupus erythematosus, and inflammatory bowel disease. [niaid.nih.gov]
Skin
- Urticaria
Rhinoconjunctival syndrome was diagnosed in 180 (97.8%) patients, pollen induced bronchial asthma in 76 (41.3%) and pollen induced urticaria in 35 (19.0%) patients. [ncbi.nlm.nih.gov]
[…] pustules rarely reaction resemble scalp scaly scarlatiniform scars scleroderma scratch seborrheic dermatitis sensitization serum skin sometimes subcutaneous surface symptoms syndrome Syph syphilis therapy thickening tion toxic treatment tumors ulcers urticaria [books.google.com]
Claratyne Tablets provide non-drowsy, rapid 24 hour relief from the symptoms of hayfever, year round allergies and chronic urticaria (hives). One daily dose provides relief from: - Sneezing - Runny nose - Watery, itchy eyes - Itchy rash [bayer.com.au]
"Urticaria, Angioedema, and Allergic Rhinitis." 'Harrison's Principles of Internal Medicine, 20e' Eds. NY: McGraw-Hill. pp. Chapter 345. ISBN 978-1-259-64403-0. ^ a b c d "American Academy of Allergy Asthma and Immunology". ^ "Allergy Tests". [en.wikipedia.org]
Martin Metz and Marcus Maurer, Rupatadine for the treatment of allergic rhinitis and urticaria, Expert Review of Clinical Immunology, 7, 1, (15), (2011). Z. A. Randriamanantany, I. Annesi‐Maesano, D. Moreau, C. Raherison, D. Charpin, C. [doi.org]
Eyes
- Redness of Eye
Pollen grains can set off an allergic reaction as the conjunctiva (the transparent membrane covering the white of the eye) becomes inflamed causing watery, red, itchy eyes. [lookafteryoureyes.org]
Itchy, red, watery eyes Runny or stuffy nose Sneezing Your symptoms come and go depending on the season. Your doctor can tell if you have seasonal allergies by asking questions about your symptoms and whether they happen during certain seasons. [merckmanuals.com]
The drops provide rapid relief from itchy, red, watery eyes. [netdoctor.co.uk]
- Excessive Tearing
Complications of this allergic rhinitis include the following: Acute or chronic sinusitis Otitis media Sleep disturbance or apnea Dental problems (overbite): Caused by excessive breathing through the mouth Palatal abnormalities Eustachian tube dysfunction [emedicine.com]
- Lacrimation
Seasonal variety of allergic rhinitis, marked by acute conjunctivitis with lacrimation and itching; regarded as an allergic condition triggered by specific allergens. [icd9data.com]
Face, Head & Neck
- Epistaxis
headache, nasal irritation, sedation $50 ($145) for 1 nasal spray Olopatadine (Patanol) [corrected] C 6 years Block H 1 receptors; onset of action is 30 minutes Bitter aftertaste, epistaxis, headache, nasal irritation, sedation $50 ($250) for 1 nasal [aafp.org]
APARATO RESPIRATORIO R01 Dolor atribuido al aparato respiratorio R02 Fatiga respiratoria/disnea R03 Respiración jadeante/sibilante R04 Otros problemas de la respiración R05 Tos R06 Epistaxis/hemorragia nasal R07 Estornudos/congestión nasal R08 Otros signos [iqb.es]
Significant local adverse effects: epistaxis. [doi.org]
leading to release of various inflammatory mediators that cause the symptoms we recognize as AR, including sneezing; nasal congestion; stuffiness; rhinorrhea (runny nose); cough; itching of the nose, eyes, and throat; sinus pressure; headache; and epistaxis [emedicine.com]
Neurologic
- Headache
Headache frequency seems to have a greater impact on the association with respiratory or allergic conditions than headache diagnoses. [ncbi.nlm.nih.gov]
In addition to allergies, ENT specialists treat deviated septum, rhinitis, sinusitis, sinus headaches and migraines, nasal obstruction and surgery, and more. Dr. Spencer C. [entnet.org]
(As if that weren’t enough, hay fever sufferers are also commonly subjected to a range of other afflictions such as eczema and asthma, and even migraine headaches and depression.) [giantmicrobes.com]
- Confusion
Hay fever and colds are easy to confuse because they share the clinical category of rhinitis, which means irritation and inflammation of the nasal cavity. [theconversation.com]
They include sleepiness, dry mouth, blurred vision, constipation, difficulty with urination, confusion, and light-headedness. Decongestants are also available over the counter as nose drops or sprays. [merckmanuals.com]
“It is very easy to get this confused because a lot of the symptoms are quite similar. The things that differentiate a cold from an allergy are generally when it appears, how quickly it appears and how long it lasts,” Selena says. [healthpartners.com.au]
Infections Common cold: frequent colds can sometimes be confused with allergies. Colds will typically last 7-10 days and are often accompanied by yellow or green nasal discharge. [clarityallergycenter.com]
- Burning Sensation
Some may cause side effects, such as a stinging or burning sensation in your eyes. Immunotherapy If you have persistent hay fever symptoms that aren't relieved by the above treatments, your GP may refer you for immunotherapy treatment. [nhsinform.scot]
Workup
Allergy testing often shows what allergens an individual is sensitive to. The most common form of allergy testing is skin testing [8]. This often involves a patch test to see what particular substances are causing the condition. In less common situations, the suspected allergen is dissolved and dropped onto the lower eyelid as a means of testing for allergies. The lower eyelid test may be harmful when done improperly. When it is established that an individual cannot undergo skin testing, the RAST blood test is helpful in determining specific allergen sensitivity. In a differential leukocyte count, peripheral eosinophilia is seen.
Colonoscopy
- Polyps
Other separate articles related to this topic include Non-allergic Rhinitis, Nasal Polyps, Sinusitis and the general article Rhinitis and Nasal Obstruction. [patient.info]
If nasal obstruction or nasal polyps are evident, sinus surgery may be necessary. [verywellhealth.com]
A nasal endoscopy allows your doctor to look for: Nasal polyps Sinus infection Nasal tumors Cerebrospinal fluid (CSF) leaks Nasal endoscopy is also often used after surgery to help clean the sinus passages and improve healing. [wexnermedical.osu.edu]
Nasal polyps: nasal polyps are benign grape-like growths that block the nasal and sinus passages. Nasal congestion and post-nasal drainage can be severe and can often cause a decreased sense of smell. [clarityallergycenter.com]
Treatment
The main goal of treatment is to prevent or reduce the symptoms that are brought about with the inflammation of the affected tissues [9]. Measures that have been proven effective include avoiding the allergen. When medications are required, intranasal corticosteroids are the preferred treatment. Other options can be used when these turn out to be ineffective. Antihistamines and steroids are also effective.
Prognosis
Prognosis is very positive because in many cases, hay fever is successfully managed by minimising exposure to the allergens and treatment with one or more medications [6]. Without medical treatment, many people with hay fever find their symptoms diminish as they get older.
Etiology
Allergic rhinitis is triggered by the pollens of specific seasonal plants. It is known as hay fever because its prevalence is highest during the haying season. The condition however, can affect people round the year [2]. The causative pollen agent varies amongst individuals and also from region to region but in general, the pollens of wind-pollinated plants are the main cause. Pollens of insect pollinated plants cannot cause allergic rhinitis because they are not able to remain airborne for long and do not carry any risks [3]. Below are some plants that have been implicated as etiologic factors for allergic rhinitis.
- Trees: Olive, linden/lime, plane, poplar, willow, horse chestnut, horn beam, hazel, cedar, alder, birch and pine.
- Grasses: Family Poaceae (mostly ryegrass (Lolium sp.) and timothy (Phelum pratense)). An estimated 90% of hay fever sufferers are allergic to grass pollen.
- Weeds: Ragweed, plantain, nettle, mugwort, fat hen and sorrel/dock.
The Balsam of Peru, which is seen in fragrances and other products, may also cause allergic rhinitis.
Epidemiology
In the United States, allergic rhinitis affects an estimated 40 million people. Recent figures also suggest a cumulative prevalence rate of 20% [4].
Internationally, the prevalence may vary within and among different countries. In Scandinavia, studies points to a 15% prevalence rate in men and 14% prevalence rate in women. This may be due to geographic differences in the types as well as potency of the overall aeroallergen burden.
Pathophysiology
Allergic rhinitis is basically an inflammation of the mucous membranes of the nose, eyes, sinuses, pharynx, middle ear and Eustachian tubes [5]. Inflammation of the mucous membranes is characterized by a complex interaction of inflammatory mediators but it is chiefly triggered by a response to an extrinsic protein triggered by an immunoglobulin E (IgE).
The ability to develop allergic or IgE mediated reactions following exposure to extrinsic allergens has a genetic composition. In individuals who are susceptible, exposure to any of the foreign proteins brings about allergic sensitisation. This is characterized by the production of specific IgE directed against these proteins.
This specific IgE coats the surface of the mast cell seen in the nasal mucosa. Following inhalation of a specific pollen grain, it binds to IgE on the mast cells and this leads to the immediate or delayed release some mediators such as histamine, tryptase, chymase, kinins, and heparin. These mediators following various interactions bring about the symptoms consistent with allergic rhinitis.
Prevention
There is no clear prevention path to avoid getting hay fever. A few suggestions point to the avoidance of exposure to allergy inducing substances such as dust mites and animal dander but there is no clear evidence on this yet as susceptible people still develops hay fever even with careful avoidance.
For people with hay fever, the best thing to do is to take steps to lessen the exposure to the allergens that cause the symptoms [10] and taking allergy medications before exposure to allergens as directed by medical personnel.
Summary
Hay fever is a condition more correctly known as allergic rhinitis. It is seen when an allergen like pollen, dust or particles off an animal such as hair or shed skin gets inhaled by an individual who has a susceptible immune system [1]. In these individuals, the allergen triggers the production of the immunoglobin E (IgE) which binds to mast cells and basophils containing histamine.
When allergic rhinitis is caused by pollens from plants, it is known as pollinosis and when it is caused by grass pollens, it is known as hay fever.
Although symptoms resembling a cold or flu can be produced following hay fever, it doesn’t bring about a fever. The disease was erroneously linked with hay because it was believed at the time that symptoms were triggered by coumarin (smell of new hay).
Patient Information
Hay fever or allergic rhinitis is a condition that causes symptoms that bear close resemblance to cold-like signs and symptoms such as runny nose, itchy eyes, congestion and sneezing. Unlike a cold though, hay fever is not caused by a virus. It is instead caused by an allergic response to outdoor or indoor pollens like pollen and dust mites.
Hay fever is a troublesome condition as it can affect performance at work or school and also interfere with leisure activities. In most cases, avoiding triggers and taken the right medication is the best way to manage the condition.
References
- May JR, Smith PH. (2008). Allergic Rhinitis. In DiPiro JT, Talbert RL, Yee GC, Matzke G, Wells B, Posey LM. Pharmacotherapy: A Pathophysiologic Approach (7th ed.). New York: McGraw-Hill. pp. 1565–75.
- Yamamoto T, Asakura K, Shirasaki H, Himi T, Ogasawara H, Narita S, Kataura A. [Relationship between pollen allergy and oral allergy syndrome]. Nippon Jibiinkoka Gakkai Kaiho 2005 108 (10): 971–9.
- Baroody FM, Brown D, Gavanescu L, Detineo M, Naclerio RM. Oxymetazoline adds to the effectiveness of fluticasone furoate in the treatment of perennial allergic rhinitis. The Journal of Allergy and Clinical Immunology 2011 127 (4): 927–34.
- Passalacqua G, Bousquet PJ, Carlsen KH, Kemp J, Lockey RF, Niggemann B, Pawankar R, Price D, Bousquet J. ARIA update: I—Systematic review of complementary and alternative medicine for rhinitis and asthma. The Journal of Allergy and Clinical Immunology 2006 117 (5): 1054–62.
- Rondón C, Fernandez J, Canto G, Blanca M. Local allergic rhinitis: Concept, clinical manifestations, and diagnostic approach. Journal of investigational allergology & clinical immunology 2010 20 (5): 364–71;
- Dykewicz MS, Fineman S, Skoner DP, et al. Diagnosis and management of rhinitis: complete guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology. American Academy of Allergy, Asthma, and Immunology. Ann Allergy Asthma Immunol 1998; 81:478.
- Wallace DV, Dykewicz MS, Bernstein DI, et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol 2008; 122:S1.
- van Cauwenberge P, Bachert C, Passalacqua G, et al. Consensus statement on the treatment of allergic rhinitis. European Academy of Allergology and Clinical Immunology. Allergy 2000; 55:116.
- Bousquet J, Khaltaev N, Cruz AA, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008; 63 Suppl 86:8.
- Bousquet J, van Cauwenberge P, Aït Khaled N, et al. Pharmacologic and anti-IgE treatment of allergic rhinitis ARIA update (in collaboration with GA2LEN). Allergy 2006; 61:1086.