Diagnosis of Chronic Rhinitis

Diagnosis

1. Medical history We check the onset time of symptoms, whether they recur, whether there are differences by season or time of day, and review the overall background including past medical history, occupational and environmental exposure, medication exposure, and general health status.

2. Endoscopy Through endoscopy, it is possible to directly examine the structure inside the nose, the condition of the nasal mucosa, and the presence of sinusitis.

3. Radiographic examination Through plain X-ray imaging or computed tomography, it is possible to identify structural abnormalities or obstructions that cannot be seen with the naked eye.

4. Skin test A person sensitized to an allergen, which is a substance that causes allergies, produces specific immunoglobulin E that reacts with the allergen. This specific antibody binds to the surface of mast cells distributed throughout the body. When the allergen enters through the skin during a skin test, the allergen and antibody combine, causing mast cells to release various chemical mediators such as histamine. Among these, histamine in particular dilates capillaries and causes wheals and redness on the skin, similar to a mosquito bite. This test measures the intensity of such a reaction to determine whether there has been sensitization to the causative allergen.

5. Measurement of specific immunoglobulin E antibodies Measuring specific immunoglobulin E antibodies in serum is a very useful method for identifying the causative allergen. In allergic diseases, blood immunoglobulin E increases. Immunoglobulin E has a strong affinity for mast cells and basophils, and when an allergen binds to these cells, various active substances are released, causing hives or asthma.

6. Eosinophil measurement If there is an allergic disease, eosinophils among the white blood cells increase. Judgment is made by examining the proportion of eosinophils among white blood cells. However, an increase in eosinophils in peripheral blood does not necessarily mean an immunoglobulin E-mediated allergic reaction and is known to rise for various other reasons as well.

7. Challenge test The principle of a challenge test is to expose the presumed allergen to the patient and induce symptoms of an allergic reaction. If a reaction occurs, this proves that the allergen is the cause of the patient's allergy.

A bronchial provocation test is used to induce bronchial asthma. Patients may be asked to inhale different kinds of allergens, to try physically inducing asthma, or to be exposed to cold, and so on. The same principle applies to rhinitis and food allergies.

Challenge tests are difficult to interpret, and if an excessive allergic reaction is provoked, an emergency situation may arise. Therefore, they should be performed by professionals in a facility equipped with the necessary preparations, equipment, and resources for such situations. This challenge test may also be used to assess the risk of symptoms or to evaluate the effects of treatment and medication.

So far, I have explained the diagnosis of chronic rhinitis. In the next part, we will look at the treatment of chronic rhinitis.

Source: Korea Disease Control and Prevention Agency, National Health Information Portal