(Disclaimer: This article is for general use only, and the following information has been processed to protect patient privacy)
Abstract: A 25-year-old female presented to the clinic with “nasal congestion for 1 month and labored breathing for 1 week”. She had been suffering from nasal congestion for 1 month and had been struggling to breathe for 1 week. Since she had been suffering from nasal congestion at this time of the year in previous years, she was not concerned at first. The patient was diagnosed with allergic rhinitis after completion of allergen skin prick test and nasal endoscopy. After active medication, the patient’s inferior turbinate edema subsided and nasal ventilation improved significantly.
Basic information】Female, 25 years old
Disease Type】Allergic rhinitis
Hospital】Northern War Zone General Hospital
Date of consultation】May 12, 2021
Treatment plan】Medication (physiological sodium chloride solution + budesonide nasal spray + azelastine hydrochloride nasal spray + ebastine tablets + methylprednisolone tablets)
Treatment period】After 5 days of outpatient medication, follow-up and 1 week of continued medication
Treatment effect】Reduction of inferior turbinate edema and significant improvement of nasal ventilation
I. Initial consultation
The patient, Ms. Liu, reported that every spring she has symptoms of itchy nose, non-ventilation, continuous sneezing, more than 10 sneezes per time, clear watery nasal discharge, and sometimes itchy eyes, and this time the patient was treated according to the previous medication regimen, including budesonide nasal spray and oral loratadine capsules, but the effect was not good. The nose was completely non-ventilated, which seriously affected normal work and life, so he came to our hospital. After completing the allergen skin prick test, it was suggested that he was allergic to willow wool, and the nasal endoscopy showed that the nasal mucosa and turbinates were pale and edematous, and they were attached to the nasal septum.
II. Treatment process
After detailed communication with the patient about his condition and treatment plan, it was decided to give him drug treatment. The nasal cavity was rinsed with physiological sodium chloride solution every day, and after the nasal cavity was cleared, two types of budesonide nasal spray and nasal spray of azelastine hydrochloride were used, along with oral administration of ebastine tablets. Because of the patient’s severe turbinate edema, additional hormone treatment was recommended. After detailed inquiry that there was no contraindication to the use of hormones, methylprednisolone tablets were given orally, and the patient was advised to follow up after 5 days of regular medication.
III. Treatment effect
The nasal endoscopy showed that the mucosa of the nasal cavity was no longer pale, the edematous inferior turbinate was significantly better than before treatment and no longer in contact with the nasal septum, and the middle turbinate could be seen directly under the nasal endoscope. Patients are advised to discontinue methylprednisolone tablets and continue to apply budesonide nasal spray and nasal spray of azelastine hydrochloride for 1 week before stopping the medication.
IV. Precautions
Patients are glad to have improvement of discomfort symptoms after medication. When the seasons change, patients can use nasal spray hormone to prevent allergic rhinitis in advance as prescribed by the doctor, commonly used drugs are budesonide nasal spray and tretinoin nasal spray. Try to avoid colds and flu, eat a light diet, and exercise properly to improve physical fitness. After the allergens are identified, reduce contact with them to reduce the chance of allergic diseases. If discomfort occurs during medication, go to the hospital promptly.
V. Personal insight
The incidence of allergic rhinitis is higher when the seasons change, and a stepwise treatment method is generally needed according to the severity of the disease. If the condition is relatively light, the simple application of nasal spray hormone can be; but if the patient’s symptoms are serious, you need to add oral anti-allergy drugs, if necessary, the application of oral hormone drugs for treatment, the patient’s nasal ventilation will be faster to recover. You also need to pay more attention to exercise, improve the body’s resistance, and try to avoid contact with allergens.