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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.
A Baltimore college student has rhinorrhea, sneezing, nasal congestion, and itchy, watery eyes in the spring. He reports having had similar symptoms the previous spring. Over-the-counter allergy pills have failed to help his symptoms and caused dry mouth and somnolence. He wants relief and assurance that he will not be ill, have dry mouth, or feel drowsy during final examinations. On physical
The Clinical Problem
Strategies and Evidence
Evaluation
History and Physical Examination
Allergy Testing
Allergen Avoidance and Pharmacotherapies
Allergen Avoidance
Oral Antihistamines
Nasal Corticosteroids
Antihistamines Combined with Nasal Corticosteroids
Leukotriene-Receptor Antagonists
Mast-Cell Stabilizers
Ophthalmic Preparations
Intranasal Agents
-Adrenergic Agonists
Systemic Corticosteroids
Algorithm-Guided Treatment
Allergen Immunotherapy
Areas of Uncertainty
Guidelines
Summary and Conclusions
Source Information
From the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md. (M.P.); and the Division of Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore (M.D.V.).
Address reprint requests to Dr. Plaut at the Asthma, Allergy and Inflammation Branch, Division of Allergy, Immunology and Transplantation, National Institute of Allergy and Infectious Diseases, 6610 Rockledge Dr., Rm. 3093, MSC-6601, Bethesda, MD 20892, or at mplaut@niaid.nih.gov.
Related Letters:
Allergic Rhinitis
Boiko P. E., Noroski L. M., Davis C., Plaut M., Valentine M. D.
Extract |
Full Text |
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N Engl J Med 2006;
354:1205-1206, Mar 16, 2006.
Correspondence
This article has been cited by other articles:
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