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Allergic Rhinitis

Howard M. Druce, MD; Michael A. Kaliner, MD
JAMA. 1988;259(2):260-263. doi:10.1001/jama.1988.03720020062038.
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SELECTED CASE  A 28-YEAR-OLD medical resident presented to the allergy clinic with a two-year history of rhinorrhea, sneezing, and nasal obstruction. His symptoms were worse in the fall, and the nasal obstruction persisted intermittently throughout the winter. Four years previously he had moved to Washington, DC, from rural Oregon. On further questioning, the patient admitted to a decreased sense of smell and some wheezing on exertion. Over-the-counter therapy with various antihistamines and decongestants had produced initial relief, but this was not sustained.For editorial comment see p 267.The results of a physical examination were normal except for a finding of pale, boggy nasal turbinates. Topical nasal decongestion revealed the presence of bilateral nasal polyps. Skin tests were performed by the prick route to a battery of inhalant allergens. Significant positive results were obtained to ragweed, molds, house dust mites, and histamine control.The patient was prescribed a vigorous program


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