Nonallergic Rhinitis (Clinical Allergy and Immunology)

506 Pages·2006·4.45 MB·English

by  James N. Baraniuk

Nonallergic Rhinitis
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CLINICAL ALLERGY AND IMMUNOLOGY
Series Editors
Michael A. Kaliner, M.D.
Medical Director
Institute for Asthma and Allergy
Washington, D.C.
Richard F. Lockey, M.D.
Professor of Medicine, Pediatrics, and Public Health
Joy McCann Culverhouse Professor of Allergy and Immunology
Director, Division of Allergy and Immunology
University of South Florida College of Medicine
and James A. Haley Veterans Hospital
Tampa, Florida
1. Sinusitis:PathophysiologyandTreatment,edited by Howard M. Druce
2. EosinophilsinAllergyandInflammation,edited by Gerald J. Gleich
and A. Barry Kay
3. MolecularandCellularBiologyoftheAllergicResponse,edited by
Arnold I. Levinson and Yvonne Paterson
4. NeuropeptidesinRespiratoryMedicine,edited by Michael A. Kaliner,
Peter J. Barnes, Gert H. H. Kunkel, and James N. Baraniuk
5. ProvocationTestinginClinicalPractice,editedbySheldon L. Spector
6. MastCellProteasesinImmunologyandBiology,edited by
George H. Caughey
7. HistamineandH-ReceptorAntagonistsinAllergicDisease,edited by
1
F. Estelle R. Simons
8. ImmunopharmacologyofAllergicDiseases, edited by Robert G. Townley
and Devendra K. Agrawal
9. IndoorAirPollutionandHealth,edited by Emil J. Bardana, Jr.,
and Anthony Montanaro
10. GeneticsofAllergyandAsthma:MethodsforInvestigativeStudies,
edited by Malcolm N. Blumenthal and Bengt Björkstén
11. AllergicandRespiratoryDiseaseinSportsMedicine,editedby
John M. Weiler
12. AllergensandAllergenImmunotherapy:SecondEdition,Revised
andEx­panded,edited by Richard F. Lockey and Samuel C. Bukantz
13. EmergencyAsthma,edited by Barry E. Brenner
14. FoodHypersensitivityandAdverseReactions,edited by Marianne Frieri
and Brett Kettelhut
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15. DiagnosticTestingofAllergicDisease,edited by Stephen F. Kemp
and Richard F. Lockey
16. InflammatoryMechanismsinAllergicDiseases,edited by
Burton Zweiman and Lawrence B. Schwartz
17. HistamineandH1-AntihistaminesinAllergicDisease,SecondEdition,
edited by F. Estelle R. Simons
18. AllergensandAllergenImmunotherapy,ThirdEdition,edited by
Richard Lockey, Samuel Bukantz, and Jean Bousquet
19. NonallergicRhinitis,edited by James N. Baraniuk and Dennis Shusterman
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Clinical Allergy and Immunology
Executive Director : Michael A. Kaliner
Nonallergic Rhinitis
edited by
James N. Baraniuk
Georgetown University Medical Center
Washington, D.C., U.S.A.
Dennis Shusterman
University of Washington
Seattle, Washington, U.S.A.
New York London
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Dedicated to the memory of Joe P.M. Braat, a rhinologist lost before his time.
ThenosewasclearlyofgreatimportancetothisearlyAegeancivilization(3500B.C.).
Thenosewastheonlyorgandisplayedonthebroadfacesoftheirstatues.
Remembering the past will inspire the future.

Series Introduction
Rhinitisisanincrediblycommondisease:Everyonesuffersfrominfectiousrhinitis,
often on an at least yearly basis. Allergic rhinitis affects at least 60 million
Americans,andtheestimatefornonallergicrhinitisisanother10–20million.Prob-
ably because allergic rhinitis has been recognized for a century or more, and
because the symptoms of allergic and nonallergic rhinitis overlap, most clinicians
donotdistinguishallergicfromnonallergicrhinitis.Infact,evenamongspecialists,
patientsarenotcarefullyclassifiedintoallergic,nonallergicormixedrhinitis(ele-
ments of both diseases). Most patients are treated as if they have allergic disease;
althoughboth the pathophysiologyandeffective treatmentsof thesetwo diseases
are quite distinct. In fact, there are multiple causes of nonallergic rhinitis, each of
whichisdistinct.Nonallergic‘‘vasomotor’’rhinitisisthemostcommonform,and
evenrhinologistshavedifficultyclearlydistinguishingwhichformsofnonallergic
rhinitis are present.
To our knowledge, no books have focused on nonallergic rhinitis, elabora-
ting what is known about pathophysiology, epidemiology or treatment. Thus,
Baraniuk’s and Shusterman’s book, ‘‘Nonallergic Rhinitis’’ fills an extremely
important clinical gap.
Atleastonehalfthepatientsseenwithrhinitishaveeithernonallergicrhinitis
asanexclusivecauseoftheirsymptomsorhaveanimportantelementofnonallergic
disease complicating allergic rhinitis. White we believe that the primary group of
cliniciansinterestedinthistopicwillbeAllergistsandOtolaryngologists,mostclin-
icianswouldbenefitfromanincreasedunderstandingofthesigns,symptomsand
pathophysiologiceventsthatseparatenonallergicfromallergicdisease,andmany
millionsofpatientswouldappreciatemoreeffectivetreatmentoftheirnasaldisease
ifcliniciansdidunderstandtheseimportantdifferences.
Thus, it is a pleasure to welcome this book to the ‘‘Clinical Allergy and
Immunology’’ series. It accomplishes what we set out to do in this series: bridge
basic science with clinical practice, enhancing the treatment of patients.
Michael A. Kaliner, MD
Richard Lockey, MD
v