Diagnosis and Management of Rhinitis: Complete guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology

This document contains complete guidelines for diagnosis and management of rhinitis developed by the Joint Task Force on Practice Parameters in Allerg y, Asthma and Immunology, representing the American Academy of Allergy, Ast hma and Immunology, the American College of Allergy, Asthma and Immunology and the Joint Council on Allergy, Asthma and Immunology. The guidelines are comprehensive and begin with statements on clinical characteristics and di agnosis of different forms of rhinitis (allergic, non-allergic, occupationa l rhinitis, hormonal rhinitis [pregnancy and hypothyroidism], drug-induced rhinitis, rhinitis from food ingestion), and other conditions that may be c onfused with rhinitis. Recommendations on patient evaluation discuss approp riate use of history, physical examination, and diagnostic testing, as well as unproven or inappropriate techniques that should not be used. Parameter s on management include use of environmental control measures, pharmacologi c therapy including recently introduced therapies and allergen immunotherap y. Because of the risks to patients and society from sedation and performan ce impairment caused by first generation antihistamines, second generation antihistamines that reduce or eliminate these side effects should usually b e considered before first generation antihistamines for the treatment of al lergic rhinitis. The document emphasizes the importance of rhinitis managem ent for comorbid conditions (asthma, sinusitis, otitis media). Guidelines a re also presented on special considerations in patients subsets (children, the elderly, pregnancy, athletes and patients with rhinitis medicamentosa); and when consultation with an allergist-immunologist should be considered.