내과의사를 위한 알레르기비염 진료지침
Clinical Practice Guideline for Physicians on Allergic Rhinitis
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Recently, the rhinitis work group of the Korean Academy of Asthma, Allergy and Clinical Immunology developed a practice guideline on allergic rhinitis. The group consisted of physicians, pediatricians, and otolaryngologists. Here, the guideline is adapted for clarity and for ease of use by physicians. To manage allergic rhinitis well, accurate diagnosis is most important. In patients with rhinitis symptoms, the first step is to perform a skin prick test to inhalant allergens, and/or to measure allergen-specific immunoglobulin E in serum. Next, allergic rhinitis should be diagnosed upon documenting the association between positive allergens and rhinitis symptoms, via patient history or allergen nasal provocation test. Allergic rhinitis should be differentiated from non-allergic rhinitis, because treatment modalities differ between the two. Allergic rhinitis should be effectively managed with allergen avoidance, pharmacotherapy, allergen immunotherapy, surgical treatment, and/or saline irrigation. Second-generation antihistamines or leukotriene modifiers may be used for mild-to-moderate forms, and intranasal steroids may be effective for moderate-to-severe forms. Allergic rhinitis is closely associated with asthma. Spirometry should be performed initially for asthma diagnosis, if asthma-like symptoms are present.
Abstract
Recently, the rhinitis work group of the Korean Academy of Asthma, Allergy and Clinical Immunology developed a practice guideline on allergic rhinitis. The group consisted of physicians, pediatricians, and otolaryngologists. Here, the guideline is adapted for clarity and for ease of use by physicians. To manage allergic rhinitis well, accurate diagnosis is most important. In patients with rhinitis symptoms, the first step is to perform a skin prick test to inhalant allergens, and/or to measure allergen-specific immunoglobulin E in serum. Next, allergic rhinitis should be diagnosed upon documenting the association between positive allergens and rhinitis symptoms, via patient history or allergen nasal provocation test. Allergic rhinitis should be differentiated from non-allergic rhinitis, because treatment modalities differ between the two. Allergic rhinitis should be effectively managed with allergen avoidance, pharmacotherapy, allergen immunotherapy, surgical treatment, and/or saline irrigation. Second-generation antihistamines or leukotriene modifiers may be used for mild-to-moderate forms, and intranasal steroids may be effective for moderate-to-severe forms. Allergic rhinitis is closely associated with asthma. Spirometry should be performed initially for asthma diagnosis, if asthma-like symptoms are present.
참고문헌 (24)
- Settipane RA, "Current Review of Rhinitis", pp.55~68 (2006), Current Medicine
- Rhinitis work group, "Clinical practice guideline for allergic rhinitis" (2015), The Korean academy of asthma, allergy and clinical immunology
- Kim YH, "Clinical diagnostic guidelines for allergic rhinitis: diagnosis", J Korean Med Assoc, 60, pp.81~88 (2017)
- 김영효, "임상의를 위한 알레르기비염 진료지침: 내과적 치료", 대한의사협회지, 60(2), pp.183~193 (2017), 대한의사협회[DOI]
- 김영효, "임상의를 위한 알레르기비염 진료지침: 포괄적 치료및 특수상황에 대한 고려", 대한의사협회지, 60(3), pp.257~269 (2017), 대한의사협회[DOI]
- Di Lorenzo G, "Differences and similarities between allergic and nonallergic rhinitis in a large sample of adult patients with rhinitis symptoms", Int Arch Allergy Immunol, 155, pp.263~270 (2011)
- Huggins KG, "Letter: Local IgE antibodies in allergic rhinitis", Lancet, 2, pp.618~ (1975)
- Rondón C, "Local IgE production and positive nasal provocation test in patients with persistent nonallergic rhinitis", J Allergy Clin Immunol, 119, pp.899~905 (2007)
- Orban NT, "Middleton's Allergy: Principles and Practice", pp.973~990 (2009), Mosby Elsevier
- Bousquet J, "Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the world health organization, GA(2)LEN and AllerGen)", Allergy, 63(Suppl 86), pp.8~160 (2008)
- Banov CH, "Efficacy of azelastine nasal spray in the treatment of vasomotor (perennial nonallergic) rhinitis", Ann Allergy Asthma Immunol, 86, pp.28~35 (2001)
- Seidman MD, "Clinical practice guideline: allergic rhinitis", Otolaryngol Head Neck Surg, 152(1 Suppl), pp.S1~S43 (2015)
- Wei C, "The efficacy and safety of H1-antihistamine versus montelukast for allergic rhinitis: a systematic review and meta-analysis", Biomed Pharmacother, 83, pp.989~997 (2016)
- Mucha SM, "Comparison of montelukast and pseudoephedrine in the treatment of allergic rhinitis", Arch Otolaryngol Head Neck Surg, 132, pp.164~172 (2006)
- Benninger MS, "Techniques of intranasal steroid use", Otolaryngol Head Neck Surg, 130, pp.5~24 (2004)
- Mener DJ, "Topical intranasal corticosteroids and growth velocity in children: a meta-analysis", Int Forum Allergy Rhinol, 5, pp.95~103 (2015)
- Minshall E, "Assessment by nasal biopsy of long-term use of mometasone furoate aqueous nasal spray (Nasonex) in the treatment of perennial rhinitis", Otolaryngol Head Neck Surg, 118, pp.648~654 (1998)
- Vlastarakos PV, "Functional endoscopic sinus surgery improves sinus-related symptoms and quality of life in children with chronic rhinosinusitis: a systematic analysis and meta-analysis of published interventional studies", Clin Pediatr (Phila), 52, pp.1091~1097 (2013)
- Hermelingmeier KE, "Nasal irrigation as an adjunctive treatment in allergic rhinitis: a systematic review and meta-analysis", Am J Rhinol Allergy, 26, pp.e119~e125 (2012)
- Leynaert B, "Association between asthma and rhinitis according to atopic sensitization in a population-based study", J Allergy Clin Immunol, 113, pp.86~93 (2004)
- Settipane RJ, "IgE and the allergy-asthma connection in the 23-year follow-up of brown university students", Allergy Asthma Proc, 21, pp.221~225 (2000)
- Togias A, "Rhinitis and asthma: evidence for respiratory system integration", J Allergy Clin Immunol, 111, pp.1171~1183 (2003)
- Incaudo GA, "Diagnosis and treatment of allergic rhinitis and sinusitis during pregnancy and lactation", Clin Rev Allergy Immunol, 27, pp.159~177 (2004)
- American Academy of Pediatrics Committee on Drugs, "Transfer of drugs and other chemicals into human milk", Pediatrics, 108, pp.776~789 (2001)