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Allergic Rhinitis

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Table 2. Summary of Guideline Key Action Statements (KAS) Statement Action Strength 1. Patient History and Physical Examination Clinicians should make the clinical diagnosis of AR when patients present with a history and physical exam consistent with an allergic cause and one or more of the following symptoms: nasal congestion, runny nose, itchy nose, or sneezing. Findings of AR consistent with an allergic cause include, but are not limited to, clear rhinorrhea, nasal congestion, pale discoloration of the nasal mucosa, red and watery eyes. R-C 2. Allerg y Testing Clinicians should perform and interpret, or refer to a clinician who can perform and interpret, specific IgE (skin or blood) allerg y testing for patients with a clinical diagnosis of AR who do not respond to empiric treatment, or when the diagnosis is uncertain, or when knowledge of the specific causative allergen is needed to target therapy. R-B 3. Imaging Clinicians should NOT routinely perform sinonasal imaging in patients presenting with symptoms consistent with a diagnosis of AR. R-C (against) 4. Environmental Factors Clinicians may advise avoidance of known allergens or may advise environmental controls (i.e., removal of pets, the use of air filtration systems, bed covers, and acaricides [chemical agents that kill dust mites]) in AR patients who have identified allergens that correlate with clinical symptoms. O-B 5. Chronic Conditions and Comorbidities Clinicians should assess and document in the medical record patients with a clinical diagnosis of AR for the presence of associated conditions such as asthma, atopic dermatitis, sleep-disordered breathing, conjunctivitis, rhinosinusitis and otitis media. R-B 6. Topical Steroids Clinicians should recommend INSs for patients with a clinical diagnosis of AR whose symptoms impact their quality of life. S-A Key Points 2

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