Review

Non-allergic rhinitis: a case report and review

Cyrus H Nozad¹ , L Madison Michael^2,3 , D Betty Lew¹ and Christie F Michael¹

¹  Division of Clinical Immunology, University of Tennessee Health Science Center, 50 North Dunlap St, RM 401 WPT, Memphis, TN, USA

²  Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA

³  Semmes-Murphey Neurologic and Spine Center, 6325 Humphreys Blvd, Memphis, TN, USA

author email corresponding author email

Clinical and Molecular Allergy 2010, 8:1doi:10.1186/1476-7961-8-1

Published:	3 February 2010

Abstract

Rhinitis is characterized by rhinorrhea, sneezing, nasal congestion, nasal itch and/or postnasal drip. Often the first step in arriving at a diagnosis is to exclude or diagnose sensitivity to inhalant allergens. Non-allergic rhinitis (NAR) comprises multiple distinct conditions that may even co-exist with allergic rhinitis (AR). They may differ in their presentation and treatment. As well, the pathogenesis of NAR is not clearly elucidated and likely varied. There are many conditions that can have similar presentations to NAR or AR, including nasal polyps, anatomical/mechanical factors, autoimmune diseases, metabolic conditions, genetic conditions and immunodeficiency. Here we present a case of a rare condition initially diagnosed and treated as typical allergic rhinitis vs. vasomotor rhinitis, but found to be something much more serious. This case illustrates the importance of maintaining an appropriate differential diagnosis for a complaint routinely seen as mundane. The case presentation is followed by a review of the potential causes and pathogenesis of NAR.