Hayfever (Allergic Rhino-conjunctivitis)

Allergic rhino-conjunctivitis affects up to 20% of children and can significantly impair quality of life. Dr George Du Toit has extensive experience in the administration of Immunotherapy. This therapy is one of a few potentially curative therapies. SLIT has an excellent safety profile. Please contact the Practice Manager for costs and logistics associated with SLIT.  
 
For a list of the aero-allergies we commonly encounter and test for, click here. To access the daily pollen count please click here or see attached calender below.
 
Background information with regard to hay fever

 

Symptoms and Signs:
 
In addition to the classic presentation of coryza and conjunctivitis, hay fever may present with many other, sometimes less well recognised symptoms and signs. These include symptoms due to post-nasal drip, for example, cough-variant rhinitis, irritating throat-clearing noises and, if excess mucous is swallowed, gut pain and nausea. 
  • Other features include allergic mannerisms, for example, the so-called allergic salute and itch-induced facial distortion. Mouth breathing, with associated snoring and dry dentition predisposes a child to dental caries and halitosis. Dry cracked lips are often associated with a lip-licking eczema. The sensations of taste and smell are significantly impaired in severe rhinitis and a nasal quality speech may be present. Adenoidal hypertrophy, which may obstruct the osteo-meatal complex predisposes the child to sinusitis, poor sleep, and middle ear effusions, with reduced hearing. Extreme eye rubbing may result in superficial corneal ulcers. Disrupted breathing patterns may impair sleep, rendering sufferers fatigued during the day. Concomitant inappropriate prescription of sedating antihistamines may exacerbate daytime fatigue, which impairs school performance and alters behaviour.
School exams in the UK are taken during the pollen season and studies suggest that untreated or inappropriately treated hay fever will impact on school performance. Rhino-conjunctivitis affects the normal functioning of the Eustachian tube, which predisposes the child to middle ear effusions and decreased hearing. The nasal mucosa represents the start of an airway that terminates in the alveoli. This important concept of a ‘combined airway’ is born out by the fact that treatment of allergic rhinitis alone has been shown to improve coexistent asthma.
 
Causes/triggers:  Seasonal allergic rhinitis or hay fever is predominantly due to sensitisation and exposure to airborne pollens and spores (tree pollens in spring, grass pollens in summer, and mould spores in autumn). Perennial allergic rhinitis is usually due to sensitisation and exposure to house dust mite or ongoing exposure to an allergen, such as a pet to which the child is sensitised.  
 
Helpful UpToDate resources
 

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  • pollencalendar.pdf - on 23 Apr 2009 14:12 by George du Toit (version 1)
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