Donna’s symptoms of itchy eyes, nasal congestion, watery nasal discharge, tickling cough, and repetitive sneezing indicate that she is experiencing allergic rhinitis. Allergic rhinitis is an inflammatory response in the nasal passages and airways triggered by the body’s immune system in response to exposure to airborne allergens. It is a common condition, particularly in individuals with a history of seasonal allergies.
In Donna’s case, her symptoms occur in December, suggesting that she may have seasonal allergic rhinitis, also known as hay fever. Seasonal allergic rhinitis is typically triggered by pollens from trees, grasses, and weeds that are prevalent during specific times of the year. Donna mentions that she gets frequent “colds” every spring and fall, which further supports a seasonal pattern for her symptoms.
The pathophysiology of allergic rhinitis involves an overreaction of the immune system to harmless substances, such as pollen or dust mites. When these allergens enter the body, they are recognized as foreign by the immune system. This recognition triggers the release of histamine and other inflammatory mediators, leading to the characteristic symptoms of allergic rhinitis.
Histamine is released by mast cells, which are present in high numbers in the nasal mucosa. Histamine causes increased blood flow to the nasal tissues and an increase in the production of mucus. These responses result in nasal congestion, pruritus (itching), and rhinorrhea (nasal discharge).
The release of histamine also causes vasodilation and increased capillary permeability, leading to the redness and swelling of the sclera (the white part of the eye) and the irritation of the outer nares (nostrils).
In addition to histamine, other inflammatory mediators, such as leukotrienes and prostaglandins, are released during the allergic response. These mediators further contribute to the inflammation and symptoms associated with allergic rhinitis.
The presence of polyps in Donna’s nasal passages is also indicative of allergic rhinitis. Polyps are noncancerous growths that can develop in the nasal cavity and sinuses in response to chronic inflammation. The chronic inflammation associated with allergic rhinitis can lead to hypertrophy (enlargement) of the nasal mucosa, as well as the formation of polyps.
To diagnose allergic rhinitis, Donna’s nurse practitioner may perform a thorough physical examination, including an evaluation of her nasal passages and sinuses. The practitioner may also use the patient’s medical history and a detailed description of her symptoms to establish a diagnosis. In some cases, allergy testing may be conducted to identify specific allergens that trigger Donna’s symptoms.
Once diagnosed, treatment for allergic rhinitis focuses on symptom management and avoidance of allergens when possible. Medications, such as antihistamines, can help alleviate symptoms by blocking the action of histamine. Intranasal corticosteroids may also be prescribed to reduce inflammation in the nasal passages. In severe cases, immunotherapy, such as allergy shots, may be considered to desensitize the immune system to specific allergens.
In conclusion, Donna is likely experiencing allergic rhinitis, specifically seasonal allergic rhinitis, due to her symptoms occurring in December and her history of seasonal allergies. The pathophysiology of allergic rhinitis involves an immune system overreaction to harmless allergens, leading to the release of histamine and other inflammatory mediators. These mediators cause the characteristic symptoms of nasal congestion, rhinorrhea, itching, and sneezing. Treatment for allergic rhinitis focuses on symptom management and avoidance of allergens.