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Allergen: A substance that triggers an allergic reaction.

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Allergic Rhinitis: An allergy affecting the mucus membrane of the nose. Seasonal allergic rhinitis is often called "hay fever."

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Allergist: A doctor that diagnoses, treats, and manages allergy-related conditions.

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Ana-Kit: A device used to inject epinephrine during an anaphylaxis attack.

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Anaphylaxis: A life-threatening allergic reaction that involves the entire body. Anaphylaxis may result in shock or death, and thus requires immediate medical attention

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Animal dander: The small scales or pieces of skin, often containing proteins secreted by oil glands, which are shed by an animal. These proteins are the major causes of allergies to pets.

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Antibiotics: A class of medications used to treat bacterial infections. Certain antibiotics, such as penicillin, may cause an allergic reaction in some people.

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Antibody: A protein in the immune system that recognizes and attacks foreign substances in the body.

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Anticonvulsant: A medication used to prevent or treat seizures. Certain anticonvulsants may cause an allergic reaction in some people.

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Antihistamines: A class of medications used to block the action of histamines in the body and prevent the symptoms of an allergic reaction.

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Asthma: An inflammatory disorder of the airways, causing periodic attacks of wheezing, coughing, chest tightness, and shortness of breath.

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Atopic dermatitis: A chronic skin rash, also known as "eczema," that often appears in the first few years of life.

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Basophil: An immune system cell that attaches to antibodies and circulates through out the blood.

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Beta-blockers: A class of blood pressure medications that ease the heart's pumping action and widen the blood vessels. Beta-blockers counteract the effects of epinephrine used for emergency treatment of anaphylactic shock and should not be used during immunotherapy.

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Bronchial tubes: The lower sections of the airway that lead into the lungs.

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Challenge test: A test used to confirm an allergy to specific substance. A doctor will administer small but increasing amounts of a suspected allergen until an allergic response is noticed. Due to the risk of anaphylaxis, this should only be performed under a controlled setting.

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Conjunctivitis: Inflammation of the conjunctiva, or the mucous membrane surrounding the eye. Also known as pinkeye.

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Contact dermatitis: An allergic reaction resulting from skin contact to an allergen.

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Corticosteroid: An anti-inflammatory medication used to treat the itching and swelling associated with some allergic reactions.

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Cromolym sodium: An anti-inflammatory nasal spray used to treat and sometimes prevent allergic rhinitis.

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Decongestants: A class of medications used for nasal congestion. Decongestants are available in oral doses, nasal sprays, or eye drops (for conjunctivitis).

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Dust mites: A microscopic organism that lives in dust.

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Eczema: See Atopic dermatitis.

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Eosinophil: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Epinepherine: A medication used for immediate treatment of anaphylaxis by raising blood pressure and heart rate back to normal levels. Epinepherine is also known as adrenaline.

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EpiPen: A device used to inject epinephrine during an anaphylaxis attack.

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Heparin: A chemical released by basophils and mast cells that causes nearby tissues to become swollen and inflamed.

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Histamine: A chemical released by basophils and mast cells that causes nearby tissues to become swollen and inflamed.

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Hives: See urticaria.

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Hypertension: High blood pressure. When blood pushes against artery walls harder than normal.

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Immunoglobulin E: A type of antibody responsible for most allergic reactions.

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Immunotherapy: A series of shots that help build up the immune system's tolerance to an allergen.

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Insulin: A hormone that regulates blood sugar levels. Diabetics who take insulin derived from animals may have allergic reactions.

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Intradermal test: A test where an allergen is injected just underneath the skin. Intradermal tests are generally used when results from a skin prick test are unclear.

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Late Phase: The period 4 - 24 hours after exposure to an allergen where tissue damage may occur.

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Leukotrienes: Inflammatory substances that are released by mast cells during an allergic response or asthma attack.

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Lymphocyte: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Mast cell: An immune system cell which attaches to antibodies and is located in the tissue that lines the nose, bronchial tubes, gastrointestinal tract, and the skin

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Neocromil sodium: An inhaled medication used to treat inflammation involved with asthma.

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Neutrophil: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Otitis media: A middle ear infection. Otitis media with effusion occurs when fluid builds up within the ear.

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Radioallergosorbant Test (RAST): A blood test that measures the amount of IgE antibody produced when the sample is mixed with a specific allergen.

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Rhinitis: An inflammation of the nasal passageways, particularly with discharge.

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Sinusitis: An inflammation or infection of one or more sinuses. The sinuses are hollow air spaces located around the nose and eyes.

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Skin prick test: A test where a needle is used to scratch the skin with a small amount of allergen. A response can usually be seen within 15 - 20 minutes.

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Urticaria: Raised areas of the skin that are often red, warm, and itchy. Urticaria is also known as hives.

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Urushiol: An oil found on poison ivy, oak, and sumac.

Hay fever (allergic rhinitis) involves an allergic reaction to pollen. A virtually identical reaction occurs with allergy to mold, animal dander, dust, and similar inhaled allergens. The pollens that cause hay fever vary from person to person and from region to region. Pollens that are carried by bees from plant to plant are seldom responsible for hay fever because the grains are large and have a waxy coating. Tiny, hard-to-see pollens carried by the wind are more often the cause of hay fever.



      Normal      Allergic rhinitis

Examples of plants commonly responsible for hay fever include:

  • Trees (deciduous and evergreen)
  • Grasses
  • Ragweed

In addition to individual sensitivity and geographic differences in local plant populations, the amount of pollen in the air can be a factor in whether hay fever symptoms develop. Hot, dry, windy days are more likely to have increased amounts of pollen in the air than cool, damp, rainy days where pollen is washed to the ground.

When an allergen such as pollen or dust is inhaled by a person with a sensitized immune system, it triggers antibody production; these antibodies bind to cells that contain histamine. Histamine (and other chemicals) are released by these cells when the antibodies are stimulated by allergens. This causes itching, swelling of affected tissues, mucus production, muscle spasms, hives, rashes, and other symptoms. Symptoms vary in severity from person to person.

Symptoms

  • Coughing
  • Headache
  • Itching of the nose, mouth, eyes, throat, skin, or any area
  • Runny nose (rhinitis)
  • Smell -- impaired
  • Sneezing
  • Sore throat
  • Stuffy nose (nasal congestion)
  • Watery eyes
  • Wheezing

History is important in diagnosing hay fever, including whether the symptoms vary according to time of day, the season, exposure to pets, diet changes, or other sources of potential allergens.

Skin testing is the most common method of allergy testing. This may include intradermal, scratch, patch, or other tests. Occasionally, the suspected allergen is dissolved and dropped onto the lower eyelid (conjunctiva) of the eye as a means of testing for allergies.

There are no specific blood tests that are commonly used to diagnose hay fever.

Treatment

The best "treatment" is to avoid what causes your allergies in the first place. It may be impossible to completely avoid everything you are allergic to, but you can often take steps to reduce your exposure.

Medication options include the following:

  • Short-acting antihistamines, which are generally non-prescription, often relieve mild-to-moderate symptoms but can cause drowsiness. In addition, these antihistamines can blunt learning in children (even in the absence of drowsiness). An example is diphenhydramine (Benadryl).
  • Longer-acting antihistamines cause less drowsiness and can be equally effective, and usually do not interfere with learning. These medications include fexofenadine (Allegra), cetirizine (Zyrtec), and loratadine (Claritin).
  • For people with symptoms not relieved by antihistamines alone, nasal corticosteroid sprays are very effective and safe. These prescription medications include fluticasone (Flonase), mometasone (Nasonex), and triamcinolone (Nasacort AQ).
  • Decongestants may also be helpful in reducing symptoms such as nasal congestion, but should not be used for long periods.
  • Cromolyn sodium is available as a nasal spray (Nasalcrom) for treating hay fever. Eye drop versions of cromolyn sodium and antihistamines are available for itchy, bloodshot eyes.

Allergy shots (immunotherapy) are occasionally recommended if the allergen cannot be avoided and symptoms are hard to control. It includes regular injections of the allergen, given in increasing doses (each dose is slightly larger than the previous dose) that may help the body adjust to the antigen.

Symptoms may sometimes be prevented by avoiding known allergens. Most trees produce pollen in the spring, grasses and flowers usually produce pollen during the summer, and ragweed and other late-blooming plants produce pollen during late summer and early autumn. During the pollen-producing times (pollen season), people with hay fever may prefer to remain indoors in an air conditioned-atmosphere whenever possible. For people that are sensitive to certain indoor allergens, dust mite covers for mattresses and pillowcases are recommended, as well as avoidance of culprit pets or other triggers.

Reference

Spector SL, Nicklas RA, Chapman JA, et al. Symptom severity assessment of allergic rhinitis: part 1. Ann Allergy Asthma Immunol. 2003;91(2):105-14.

 

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Review Date: 4/4/2007

Reviewed By: Alan Greene, M.D., F.A.A.P., Department of Pediatrics, Packard Children's Hospital, Stanford University School of Medicine; Chief Medical Officer, A.D.A.M., Inc.


The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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