Allergic Rhinitis Case Study

Eight-year-old B.J. has had asthma for 2 years since he had acute bronchitis. He was tested for allergies and demonstrated marked responses to a number of animals, pollens, and molds. B.J. also has a history of asthma related to exposure to very cold weather.

Dad reports that she first had what looked like a pimple about seven or 10 days ago on her nose. Since then, without really fussing with it, she has developed these scabbed areas that they thought she should have looked at. They do not seem to be getting better. Dad has noticed since he first started, that they perhaps seem a little bit redder. Mom has been putting some Neosporin on it, but it does seem to be making much of a difference. She has had just a very mild cold symptoms in the last couple of weeks, but nothing major. She has not been coughing. She does not seem particularly stuffy. She is not sneezing, per dad. She does have a history of asthma and there has been no increased asthma symptoms. She does get nosebleeds intermittently per dad and she has had a couple in the last week. He is not sure if that is related or not. He says that he is able to stop them very quickly and they have not noticed any other major issues. She had no other skin issues that they have seen. These nose symptoms that she is having are not painful. They do not seem to be itchy and they really do not bother her and without looking in the mirror, she says she would not have realized that they are there.

Pamela was seen today following her trial of Alvesco and her stress myocardial perfusion scan. Reassuringly, the stress myocardial perfusion scan was normal showing godd ventricular function and no obvious evidence of ischemic heart disease.

Nonallergic rhinitis is the term used to describe a combination of symptoms resembling an allergic reaction that cannot be linked to a specific cause. It is a very common condition, with as much as 25% of the adult population exhibiting symptoms. Oftentimes, the condition can only be confirmed after the possibility of other medical issues has been ruled out.

Allergic rhinitis is started by an allergic immune response to inhaled allergens. Atopic people have a genetic predisposition to become sensitised to harmless allergens. Dendritic cells which act as antigen-presenting cells capture the allergen and present allergenic peptide to T lymphocytes in lymph nodes. CD4+ T cells play an important role in starting and orchestration of the allergic immune response by secretion of cytokines such as interleukins 4, 5, 10, and 13. Interleukin 4 is fundamental cytokine in driving sensitisation to allergens. Interleukin 4 stimulatesthe IgE switch in B lymphocytes. After releasing of IgE into the bloodstream it binds to receptors on the surface of mast cells and basophils. When the patient exposure to the allergen and the allergen reach nasal mucosa of sensitised individuals, they bind allergen-specific IgE on the surface of mast cells, resulting in release of inflammatory mediators such as histamine.

Allergic rhinitis and allergic asthma are complex and heterogeneous diseases. Many pathological mechanimes are implicated to create a clinical picture. Phenotypes and endotypes are modern concepts created in order to help scientists and clinicians to characterize, diagnose and treat better this conditions. Genetics has important roles in this classification. This article takes a short review of this important concepts.

Allergic rhinitis” is very comnon disease affects about 5-22% from world population with about 9% of all visits to physicians” for the allergic diseases [1].

Annonymous. (2007). Treatment of allergic rhinitis. Allergy, 49(s19), 19-34. doi: 10.1111/j.1398-9995.1994.tb04246.x

Mr. Franklin is a 38 yo male with a history of reactive airway disease who presents today complaining of RLQ stomach pain that started yesterday on his way home from work and progressively got worse overnight. He describes his pain as sharp when moving, dull and crampy when not moving. It does not radiate. Early this morning he had an episode of nausea and vomiting that temporarily subdued his pain. He took Aspirin about 4-5 hours ago for the pain though it didn’t help. He hasn’t had a BM in 3 days but it is not abnormal for him. He denies diarrhea or constipation. His vitals are normal with a slightly elevated temp. of 99.4. Mr. Franklin is coughing a lot today. He said that he is always coughing a little and that he is always congested. He

You make an excellent point by mentioning the effects of the exposure on those who have conditions such as respiratory illnesses and asthma. In addition to your thoughts, the National Resources Defense Council states, “Roughly thirty percent of childhood asthma is due to environmental exposures, costing the nation two billion per year” (2014). Additionally, people who have not been diagnosed with asthma are said to develop constricted and swollen airways after environmental exposures. Taking into consideration the case that occurred in Kingston, Tennessee, I would conclude that respiratory illnesses soared directly following the incident. In your opinion, what would be the best intervention to alleviate the consequences of the coal

The patient tells me her symptoms started last Thursday. She started with a cough and she is also noticing some congestion and her ears are feeling blocked. That is a newer symptom for her. She has had a sore throat, but she is not sure if it is truly a sore throat or whether it is just from her coughing. She has not checked her temperature, but has felt chilled and achy at times, but is not sure if she has had a fever. She has also been taking Advil. She does not feel short of breath, but the cough is keeping her up at night. She does not have a history of asthma. She does not use inhalers on a regular basis. About a month and a half ago, she had some

Ms. Anastas is a 56-year-old female here today to follow up for her asthma. She is also considering cosmetic surgery.

Mrs. H. 43 –year- old African American female, elementary school teacher, a single mother with two kids 5 and 8 years old girls with no significant past medical history admitted on emergency room at 4:35 p.m. Her appearance was tidy, stylish and scented. She was capable of provide information. She was able to speak clearly, conscious, and coherent also she was oriented to time, place and person. She complained of a cough with whitish mucus that sometimes it ends up vomiting. She suffered chest pain and worsening dyspnea for 1 week. She stated restlessness all night and weight loss about 5 lb. during last week. She explained her worsening pain make her unable speak; she felt suffocated with shortness of breath that

Recent pathology is largely unremarkable including inflammatory markers, H pylori serology and IgE assay. RAST assay has however revealed sensitisation to dust mite and pollen and this may be an explanation for Mandy’s nocturnal nasal congestion and

I enjoyed reading your great soap note discussion. Mr. Richard symptoms did steer to disorders of acute sinusitis, chronic sinusitis, rhinovirus, sinus obstruction, and allergic rhinitis since they all have analogous symptoms. However, as you indicated the allergic rhinitis seem to be the accurate diagnosis with his working contact in the hay field. According to Church, Church, and Scadding (2016), allergic rhinitis is a widespread disorder with intensifying frequency, the current approximation indicated greater than 30 percent impact amid young adults and teenagers. Though deliberated as minor ailment by several people, allergic rhinitis symptoms are related to vicissitudes with reasoning handling deficiency and information harm (Trikojat, Buske-Kirschbaum, Schmitt, & Plessow, 2015). According to Church et al., (2016); Zuberbier, Lötvall, Simoens, Subramanian, and Church (2014), approximately 90 percent of allergic rhinitis populace either lack treatment, inadequately treated, and indecorously treated which can theoretically hamper individual’s capability to execute optimum personal