Classification and Differential Diagnosis
ÎRhinitis is classified as allergic or nonallergic, but not all types of rhinitis can be easily separated into one of these categories (eg, occupational rhinitis has been classified separately from allergic and nonallergic because it may have components of both) (refer to Table 1).1
ÎConditions that mimic symptoms of rhinitis include nasal polyps, cerebrospinal fluid rhinorrhea, ciliary dyskinesia syndrome, and structural/mechanical factors that include1
: > Cleft palate > Foreign bodies
> Deviated septum/ septal wall anomalies
Table 1. Types of Rhinitis1 I. Allergic rhinitis
A. Seasonal B. Perennial C. Episodic
II. Nonallergic rhinitis A. Vasomotor rhinitis > Irritant triggered (eg, chlorine)
> Undetermined or poorly defined triggers
B. Gustatory rhinitis C. Infectious > Acute
> Chronic
D. NARES (Nonallergic rhinitis with eosinophilia syndrome) III. Occupational rhinitis
A. Caused by protein and chemical allergens, IgE-mediated B. Caused by chemical respiratory sensitizers, immune mechanism uncertain C. Work-aggravated rhinitis
IV. Other rhinitis syndromes
A. Hormonally induced > Pregnancy rhinitis
B. Drug-induced > Rhinitis medicamentosa
> Menstrual cycle related > Oral contraceptives > Antihypertensives and cardiovascular agents
> Midline granuloma > Churg-Strauss
> Aspirin/NSAIDs > Other drugs
C. Atrophic rhinitis D. Rhinitis associated with inflammatory-immunologic disorders > Granulomatous infections > Wegener granulomatosis > Relapsing polychondritis
> Sarcoidosis > Amyloidosis
> Exercise (eg, running) > Cold Air
> Pharyngonasal reflux > Nasal tumors
> Trauma > Choanal atresia
> Adenoidal hypertrophy > Acromegaly (excess growth hormone)
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