Rhinitis Alergi

Rhinitis
Inflamasi mukosa hidung

Hidung tersumbat

Diagnosis Rhinitis Rhinorrhea

ditegakkan dengan (Anterior / Posterior)

1 atau lebih gejala Bersin

hidung Hidung Gatal

Dykewicz MS et al. Journal of Allergy and Clinical Immunology 2020

2
 Klasifikasi Rhinitis

Rhinitis

Alergi Non Alergi

Infeksi Non Infeksi

Idiopatik Structural Abnormality

Roberts G et al. Allergy 2013;68:1102–1116

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 Rhinitis Allergy (RA)

Rhinitis Alergi adalah gangguan inflamasi pada mukosa

hidung yang disebabkan oleh paparan alergen yang
memicu inflamasi yang dimediasi IgE.

Alergen  tungau debu rumah, bulu binatang, jamur, dll

Tujuan tatalaksana  kembalinya produktivitas

kerja/sekolah, kualitas hidup, kualitas tidur, dan
minimalisasi efek samping

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Allergic March

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Pathofisiologi Rhinitis Allergy

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 Tanda dan Gejala
• Rhinorrhea, hidung tersumbat, postnasal drip
• Pale nasal turbinates, with or without clear nasal
discharge
• Bersin berulang
• Gatal pada palatum, hidung, telinga, atau mata
• Snoring
• Nyeri tenggorok
• Batuk
• Nyeri kepala
Classic symptoms and signs of rhinitis

Rhinorrhoea – clear or discoloured discharge, sniffing

Pruritus - nose rubbing, the “allergic salute”, “allergic crease”, “sneeze”, may be

associated with complaints of an itchy mouth or throat in older children

Congestion
Potential- atypical
mouth breathing, snoring, sleep apnoea, allergic shiner
presentations

Eustachian tube dysfunction - ear pain on pressure changes (eg flying),

reduced hearing, chronic otitis media with effusion

Cough – often mislabelled as asthma

Poorly controlled asthma – may co-exist with asthma

Sleep problems - tired, poor school performance, irritability

Prolonged and frequent respiratory tract infections

Rhinosinusitis - catarrh, headache, facial pain, halitosis, cough, hyposmia

Pollen-food syndrome, particularly with pollen driven allergic rhinitis

Roberts G et al. Allergy 2013;68:1102–1116

Dykewicz MS et al. Journal of Allergy and Clinical Immunology 2020
Dykewicz MS et al. Journal of Allergy and Clinical Immunology 2020
Dykewicz MS et al. Journal of Allergy and Clinical Immunology 2020
ARIA
2008

Bosquet J et al. Allergy 2008

Algorithm to assess the differential diagnosis
of major rhinitis phenotype

AR, Allergic rhinitis; LAR, local allergic rhinitis; NAPT, nasal allergen provocation test; NAR, nonallergic rhinitis.
Mullol J, del Cuvillo A, Lockey RF. Rhinitis phenotypes. J Allergy Clin Immunol Pract 2020;8:1492-503.
ARIA Classification of Allergic Rhinitis

ARIA: at a glance pocket reference 2007

TATALAKSANA RA

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 ARIA Guidelines: Recommendations for
Management of Allergic Rhinitis

Moderate
Mild severe
Moderate persistent
severe persistent
intermittent
Mild
intermittent Intranasal steroid
Local cromone
Second-generation nonsedating H1 antihistamine
Intranasal decongestant (<10 days) or oral decongestant
Allergen and irritant avoidance
Immunotherapy
ARIA = Allergic Rhinitis and its Impact on Asthma.
Bousquet et al. Allergy. 2002;57:841.
Bousquet et al. Allergy. 2003;58:192.
Next Generation ARIA Guideline for Allergic Rhinitis

Bousquet J, et al. J Allergy Clin Immunol 2020

Next Generation ARIA Guideline for Allergic Rhinitis

Bousquet J, et al. J Allergy Clin Immunol 2020

INTERMITTENT ALLERGIC RHINITIS
PHARMOCOLOGIC TREATMENT
AGE 12 AND OLDER

Dykewicz MS et al. Journal of Allergy and Clinical Immunology 2020

 INTERMITTENT ALLERGIC RHINITIS
PHARMOCOLOGIC TREATMENT
AGE 12 AND OLDER

Dykewicz MS et al. Journal of Allergy and Clinical Immunology 2020

TERIMA KASIH
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