Aalergic rhinitis and VMR

Views:
 
Category: Education
     
 

Presentation Description

allergic disease of the nose and PNS

Comments

Presentation Transcript

Allergic Rhinitis : 

Allergic Rhinitis Assistant lecturer/ Hany kassamy Mohamed drkassamy@yahoo.com Mob.: 010/ 52 61 091

Definition; : 

Definition; Type I hypersensitivity reaction. IgE mediated. 10-20 %

Types ; : 

Types ; 1- Seasonal ( spring; pollens) 2- Perennial (dust mites)

Etiology; : 

Etiology; Predisposing factors Genetic ( IgE) Exciting factors  Ag (inhalant,… Aggrevating factors  Inf. ,anatomical…

Pathogenesis ; : 

Pathogenesis ; 1st exposure (+) B-lymphocytes& Plasma cells  IgE  sensitized mast cells. 2ND exposure Ag /Ab reaction mast cells Degranulation Humoral Rection ( LPSH ) 15mln. (N. &Ms. &Gl. &B.V.) (S,I & Br.Spasm & H2O Rh. & Edema ,N.O. ) Cellular Reaction (PM:L.E.) 6hs.48hs. Recruitment

C/O: : 

C/O: Paroxysmal R,S,I, N.O.  seasonal / perennial / Ag. Exposure + itchy eye ,palate, ear, urticaria , Br. Spasm +ve. Family history  e´medications  of complication : Persistent N.O.,Rec.S.

O/E: : 

O/E: Wet ,swollen ,pale bluish MM. supra tip crease  infra orbital buffiness HIT. , Nasal Polyps

Investigations; : 

Investigations; Diagnose Detect Show allergy allergen complications - Esinophilia - Skin prick - CT PNS S.T. IgE - Nasal provo- cation - RAST(sp.IgE)

Treatment ; : 

Treatment ; Medical +++ Surgical

Medical TTT. : 

Medical TTT. Ag : 1- Known A- Avoidable  avoid B- NOT  Hyposensitization 2- Unknown (L.&S.) Steroids Anti histaminics Mast cell stabilizers Anti leukotrienes

Surgical : 

Surgical 1- Aggrevating factors ;septoplasty 2- Complications; turbinectomy , polypectomy ,FESS.

Vasomotor Rhinitis : 

Vasomotor Rhinitis Chronic hypertrophic rhinitis Non specific , Non allergic , perennial

Pathogenesis; : 

Pathogenesis; Predisposing factors  Autonomic Imbalance e´ P.Symp. predominance Exciting factors hormonal ( Pg. & Menopause& T3) environmental (humidity changes … drugs (contraceptives ,B.B. , vasoconstictors) stress

C/P: : 

C/P: C/O:  persistent N.O.  R,S, e´out I O/E:  HIT. wet swollen congested MM.

TTT. : 

TTT. 1-Medical (L.&S.) Steroids  Anticholinergic  Daflon 500 mg 1x2 2- Surgical  Turbinectomy ( partial, SMD, Laser ) ?? vidian neurectomy

Slide 18: 

Many Thanks A lot of Thanks Thank you