- Home
- Search
- Tools
- CME
- Help & Feedback
- About epocrates
- Business Solutions
Highlights & Basics
- Allergic rhinitis is an immunoglobulin E (IgE)-mediated inflammatory nasal condition resulting from allergen introduction in a sensitized individual.
- Presumptive diagnosis of allergic rhinitis is usually clinical and is made if someone experiences one or more of rhinorrhea, sneezing, itching of nose/palate/eyes, or nasal congestion in response to allergen exposure. Cough is also a common symptom.
- The diagnosis is confirmed with demonstration of specific IgE reactive to environmental allergens. Food allergy testing is not recommended in the routine evaluation of rhinitis.
- Treatment includes allergen avoidance (reducing exposure to relevant allergens such as dander, dust mite, and pollen), pharmacotherapy, and immunotherapy.
- Intranasal corticosteroids remain the single most effective class of medications for treating allergic rhinitis.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
Dykewicz MS, Wallace DV, Amrol DJ, et al. Rhinitis 2020: a practice parameter update. J Allergy Clin Immunol. 2020 Oct;146(4):721-67.[Abstract][Full Text]
Scadding GK, Kariyawasam HH, Scadding G, et al. BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (revised edition 2017). Clin Exp Allergy. 2017 July;47(7):856-89.[Abstract][Full Text]
Wise SK, Lin SY, Toskala E, et al. International consensus statement on allergy and rhinology: allergic rhinitis. Int Forum Allergy Rhinol. 2018 Feb;8(2):108-352.[Abstract][Full Text]
Bousquet J, Schünemann HJ, Togias A, et al. Next-generation Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence. J Allergy Clin Immunol. 2020 Jan;145(1):70-80.e3.[Abstract][Full Text]
1. Bousquet J, Khaltaev N, Cruz AA, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008. Allergy. 2008 Apr;63 Suppl 86:8-160.[Abstract][Full Text]
2. Brożek JL, Bousquet J, Agache I, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines - 2016 revision. J Allergy Clin Immunol. 2017 Oct;140(4):950-8.[Abstract][Full Text]
3. Dykewicz MS, Wallace DV, Amrol DJ, et al. Rhinitis 2020: a practice parameter update. J Allergy Clin Immunol. 2020 Oct;146(4):721-67.[Abstract][Full Text]
4. Wallace DV, Dykewicz MS, Bernstein DI, et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008 Aug;122(2 Suppl):S1-84.[Abstract][Full Text]
5. World Health Organization. International classification of diseases, 10th revision. 2019 [internet publication].[Full Text]
6. European Academy of Allergy and Clinical Immunology. Global atlas of allergic rhinitis and chronic rhinosinusitis. Zurich, Switzerland: EAACI; 2015.[Full Text]
7. Asher MI, Montefort S, Bjorksten B, et al. ISAAC Phase Three Study Group. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006 Aug 26;368(9537):733-43.[Abstract]
8. Meltzer EO, Blaiss MS, Naclerio RM, et al. Burden of allergic rhinitis: allergies in America, Latin America, and Asia-Pacific adult surveys. Allergy Asthma Proc. 2012 Sep-Oct;33(suppl 1):S113-41.[Abstract]
9. Bauchau V, Durham SR. Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J. 2004 Nov;24(5):758-64.[Abstract][Full Text]
10. Skoner DP. Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. J Allergy Clin Immunol. 2001 Jul;108(1 Suppl):S2-8.[Abstract]
11. Pawankar R, Canonica GW, Colgate ST, et al. World Allergy Organization (WAO) white book on allergy: update 2013. Milwaukee, WI: World Allergy Organization; 2013.[Full Text]
12. Mallol J, Crane J, von Mutius E, et al; ISAAC Phase Three Study Group. The International Study of Asthma and Allergies in Childhood (ISAAC) phase three: a global synthesis. Allergol Immunopathol (Madr). 2013 Mar-Apr;41(2):73-85.[Abstract]
13. Pinart M, Keller T, Reich A, et al. Sex-related allergic rhinitis prevalence switch from childhood to adulthood: a systematic review and meta-analysis. Int Arch Allergy Immunol. 2017;172(4):224-35.[Abstract]
14. Cao Y, Wu S, Zhang L, et al. Association of allergic rhinitis with obstructive sleep apnea: a meta-analysis. Medicine (Baltimore). 2018 Dec;97(51):e13783.[Abstract][Full Text]
15. Dávila I, Mullol J, Ferrer M, et al. Genetic aspects of allergic rhinitis. J Investig Allergol Clin Immunol. 2009;19 Suppl 1:25-31.[Abstract][Full Text]
16. Evans R. Epidemiology and natural history of asthma, allergic rhinitis, and atopic dermatitis (eczema). In: Middleton E, Reed C, Ellis E, eds. Allergy: principles and practice. 4th ed. St Louis, MO: Mosby; 1993:1109-36.
17. Waage J, Standl M, Curtin JA, et al. Genome-wide association and HLA fine-mapping studies identify risk loci and genetic pathways underlying allergic rhinitis. Nat Genet. 2018 Aug;50(8):1072-80.[Abstract][Full Text]
18. Chen HI, Lin YT, Jung CR, et al. Interaction between catalase gene promoter polymorphisms and indoor environmental exposure in childhood allergic rhinitis. Epidemiology. 2017 Oct;28 Suppl 1:S126-32.[Abstract]
19. Li CH, Sayeau K, Ellis AK. Air pollution and allergic rhinitis: role in symptom exacerbation and strategies for management. J Asthma Allergy. 2020 Aug 26;13:285-92.[Abstract][Full Text]
20. Zhang Y, Tan M, Qian X, et al. Interaction between early-life pet exposure and methylation pattern of ADAM33 on allergic rhinitis among children aged 3-6 years in China. Allergy Asthma Clin Immunol. 2021 May 1;17(1):44.[Abstract][Full Text]
21. Dunlop J, Matsui E, Sharma HP. Allergic rhinitis: environmental determinants. Immunol Allergy Clin North Am. 2016 May;36(2):367-77.[Abstract]
22. Jaakkola MS, Quansah R, Hugg TT, et al. Association of indoor dampness and molds with rhinitis risk: a systematic review and meta-analysis. J Allergy Clin Immunol. 2013 Nov;132(5):1099-1110.e18.[Abstract][Full Text]
23. Christensen SH, Timm S, Janson C, et al. A clear urban-rural gradient of allergic rhinitis in a population-based study in Northern Europe. Eur Clin Respir J. 2016 Nov 26;3:33463.[Abstract][Full Text]
24. Burbank AJ, Hernandez ML, Jefferson A, et al. Environmental justice and allergic disease: a Work Group report of the AAAAI Environmental Exposure and Respiratory Health Committee and the Diversity, Equity and Inclusion Committee. J Allergy Clin Immunol. 2023 Mar;151(3):656-70.[Abstract][Full Text]
25. Shreiner A, Huffnagle GB, Noverr MC. The "Microflora Hypothesis" of allergic disease. Adv Exp Med Biol. 2008;635:113-34.[Abstract]
26. Martinez FD, Holt PG. Role of microbial burden in aetiology of allergy and asthma. Lancet. 1999 Sep;354 (suppl 2):SII12-5.[Abstract][Full Text]
27. Björkstén B. Effects of intestinal microflora and the environment on the development of asthma and allergy. Springer Semin Immunopathol. 2004 Feb;25(3-4):257-70.[Abstract]
28. Fiocchi A, Pawankar R, Cuello-Garcia C, et al. World Allergy Organization-McMaster University guidelines for allergic disease prevention (GLAD-P): probiotics. World Allergy Organ J. 2015 Jan 27;8(1):4.[Abstract][Full Text]
29. Cuello-Garcia CA, Fiocchi A, Pawankar R, et al. World Allergy Organization-McMaster University guidelines for allergic disease prevention (GLAD-P): prebiotics. World Allergy Organ J. 2016 Mar 1;9:10.[Abstract][Full Text]
30. Wang DY. Risk factors of allergic rhinitis: genetic or environmental? Ther Clin Risk Manag. 2005 Jun;1(2):115-23.[Abstract][Full Text]
31. Barnes KC, Marsh DG. The genetics and complexity of allergy and asthma. Immunol Today. 1998 Jul;19(7):325-32.[Abstract]
32. Testa D, DI Bari M, Nunziata M, et al. Allergic rhinitis and asthma assessment of risk factors in pediatric patients: a systematic review. Int J Pediatr Otorhinolaryngol. 2020 Feb;129:109759.[Abstract]
33. Wang XD, Zheng M, Lou HF, et al. An increased prevalence of self-reported allergic rhinitis in major Chinese cities from 2005 to 2011. Allergy. 2016 Aug;71(8):1170-80.[Abstract][Full Text]
34. Hassoun Y, James C, Bernstein DI. The effects of air pollution on the development of atopic disease. Clin Rev Allergy Immunol. 2019 Dec;57(3):403-14.[Abstract][Full Text]
35. Saulyte J, Regueira C, Montes-Martínez A, et al. Active or passive exposure to tobacco smoking and allergic rhinitis, allergic dermatitis, and food allergy in adults and children: a systematic review and meta-analysis. PLoS Med. 2014 Mar;11(3):e1001611.[Abstract][Full Text]
36. Wallace DV. Pet dander and perennial allergic rhinitis: therapeutic options. Allergy Asthma Proc. 2009 Nov-Dec;30(6):573-83.[Abstract]
37. National Institute for Health and Care Excellence. Clinical knowledge summaries: allergic rhinitis. Aug 2021 [internet publication].[Full Text]
38. Ojwang V, Nwaru BI, Takkinen HM, et al. Early exposure to cats, dogs and farm animals and the risk of childhood asthma and allergy. Pediatr Allergy Immunol. 2020 Apr;31(3):265-72.[Abstract]
39. Fall T, Lundholm C, Örtqvist AK, et al. Early exposure to dogs and farm animals and the risk of childhood asthma. JAMA Pediatr. 2015 Nov;169(11):e153219.[Abstract][Full Text]
40. Riedler J, Braun-Fahrlander C, Eder W, et al. Exposure to farming in early life and development of asthma and allergy: a cross-sectional survey. Lancet. 2001 Oct 6;358(9288):1129-33.[Abstract]
41. Stevenson MD, Sellins S, Grube E, et al. Aeroallergen sensitization in healthy children: racial and socioeconomic correlates. J Pediatr. 2007 Aug;151(2):187-91.[Abstract]
42. Szentpetery SE, Forno E, Canino G, et al. Asthma in Puerto Ricans: lessons from a high-risk population. J Allergy Clin Immunol. 2016 Dec;138(6):1556-8.[Abstract][Full Text]
43. Gillam SJ, Jarman B, White P, et al. Ethnic differences in consultation rates in urban general practice. BMJ. 1989 Oct 14;299(6705):953-7.[Abstract][Full Text]
44. American Academy of Allergy, Asthma & Immunology. Ten things physicians and patients should question. Choosing Wisely, an initiative of the ABIM Foundation. 2021 [internet publication].[Full Text]
45. Greer FR, Sicherer SH, Burks AW, et al; American Academy of Pediatrics: Committee on Nutrition; Section on Allergy and Immunology. The effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, hydrolyzed formulas, and timing of introduction of allergenic complementary foods. Pediatrics. 2019 Apr;143(4):e20190281.[Abstract][Full Text]
46. Kramer MS, Kakuma R. Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Cochrane Database Syst Rev. 2012 Sep 12;(9):CD000133.[Abstract][Full Text]
47. Cuello-Garcia CA, Brożek JL, Fiocchi A, et al. Probiotics for the prevention of allergy: a systematic review and meta-analysis of randomized controlled trials. J Allergy Clin Immunol. 2015 Oct;136(4):952-61.[Abstract][Full Text]
48. Obbagy JE, English LK, Wong YP, et al. Complementary feeding and food allergy, atopic dermatitis/eczema, asthma, and allergic rhinitis: a systematic review. Am J Clin Nutr. 2019 Mar 1;109(suppl_7):890S-934S.[Abstract][Full Text]
49. Grabenhenrich LB, Keil T, Reich A, et al. Prediction and prevention of allergic rhinitis: a birth cohort study of 20 years. J Allergy Clin Immunol. 2015 Oct;136(4):932-40.e12.[Abstract][Full Text]
50. American Academy of Otolaryngology--Head and Neck Surgery Foundation. Ten things physicians and patients should question. Choosing Wisely, an initiative of the ABIM Foundation. 2021 [internet publication].[Full Text]
51. Seidman MD, Gurgel RK, Lin SY; Guideline Otolaryngology Development Group. AAO-HNSF. Clinical practice guideline: allergic rhinitis. Otolaryngol Head Neck Surg. 2015 Feb;152(1 Suppl):S1-43.[Abstract][Full Text]
52. Scadding GK, Kariyawasam HH, Scadding G, et al. BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (revised edition 2017). Clin Exp Allergy. 2017 July;47(7):856-89.[Abstract][Full Text]
53. Wise SK, Lin SY, Toskala E, et al. International consensus statement on allergy and rhinology: allergic rhinitis. Int Forum Allergy Rhinol. 2018 Feb;8(2):108-352.[Abstract][Full Text]
54. Meltzer EO, Schatz M, Nathan R, et al. Reliability, validity, and responsiveness of the Rhinitis Control Assessment Test in patients with rhinitis. J Allergy Clin Immunol. 2013 Feb;131(2):379-86.[Abstract][Full Text]
55. Juniper EF, Thompson AK, Ferrie PJ, Roberts JN. Validation of the standardized version of the Rhinoconjunctivitis Quality of Life Questionnaire. J Allergy Clin Immunol. 1999 Aug;104(2 Pt 1):364-9.[Abstract]
56. Juniper EF, Riis B, Juniper BA. Development and validation of an electronic version of the Rhinoconjunctivitis Quality of Life Questionnaire. Allergy. 2007 Sep;62(9):1091-3.[Abstract]
57. Bousquet J, Heinzerling L, Bachert C, et al. Practical guide to skin prick tests in allergy to aeroallergens. Allergy. 2012 Jan;67(1):18-24.[Abstract]
58. Hamizan AW, Rimmer J, Alvarado R, et al. Positive allergen reaction in allergic and nonallergic rhinitis: a systematic review. Int Forum Allergy Rhinol. 2017 Sep;7(9):868-77.[Abstract]
59. Blanc S, Bourrier T, Albertini M, et al. Dennie-Morgan fold plus dark circles: suspect atopy at first sight. J Pediatr. 2015 Jun;166(6):1541.[Abstract]
60. Lindberg S, Malm L. Comparison of allergic rhinitis and vasomotor rhinitis patients on the basis of a computer questionnaire. Allergy. 1993 Nov;48(8):602-7.[Abstract]
61. Sur DKC, Plesa ML. Chronic nonallergic rhinitis. Am Fam Physician. 2018 Aug 1;98(3):171-6.[Abstract][Full Text]
62. Bernstein JA, Brandt D, Ratner P, et al. Assessment of a rhinitis questionnaire in a seasonal allergic rhinitis population. Ann Allergy Asthma Immunol. 2008 May;100(5):512-3.[Abstract]
63. Meltzer EO, Hamilos DL, Hadley JA, et al. Rhinosinusitis: establishing definitions for clinical research and patient care. J Allergy Clin Immunol. 2004 Dec;114(6 Suppl):155-212.[Abstract]
64. Gurgel RK, Baroody FM, Damask CC, et al. Clinical practice guideline: immunotherapy for inhalant allergy. Otolaryngol Head Neck Surg. 2024 Mar;170 Suppl 1:S1-42.[Abstract][Full Text]
65. Okubo K, Kurono Y, Ichimura K, et al. Japanese guidelines for allergic rhinitis 2020. Allergol Int. 2020 Jul;69(3):331-45.[Abstract][Full Text]
66. Australasian Society of Clinical Immunology and Allergy (ASCIA). Australasian guidelines for allergic rhinitis 2020. 2022 [internet publication].[Full Text]
67. Bousquet J, Schünemann HJ, Togias A, et al. Next-generation Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence. J Allergy Clin Immunol. 2020 Jan;145(1):70-80.e3.[Abstract][Full Text]
68. NHS Specialist Pharmacy Service. Which oral antihistamines are safe to use whilst breastfeeding? Apr 2020 [internet publication].[Full Text]
69. Kok TH, Taitz LS, Bennett MJ, et al. Drowsiness due to clemastine transmitted in breast milk. Lancet. 1982 Apr 17;1(8277):914-5.[Abstract]
70. US Food and Drug Administration. FDA drug safety communication: FDA requires Boxed Warning about serious mental health side effects for asthma and allergy drug montelukast (Singulair); advises restricting use for allergic rhinitis. Mar 2020 [internet publication].[Full Text]
71. Australasian Society of Clinical Immunology and Allergy. Allergen minimisation. Mar 2019 [internet publication].[Full Text]
72. Sheikh A, Hurwitz B, Nurmatov U, et al. House dust mite avoidance measures for perennial allergic rhinitis. Cochrane Database Syst Rev. 2010 Jul 7;(7):CD001563.[Abstract][Full Text]
73. Vredegoor DW, Willemse T, Chapman MD, et al. Can f 1 levels in hair and homes of different dog breeds: lack of evidence to describe any dog breed as hypoallergenic. J Allergy Clin Immunol. 2012 Oct;130(4):904-9.e7.[Abstract][Full Text]
74. Liem O, Kessen K, de Groot H. Hypoallergenic animals, fact or myth? [in Dutch]. Ned Tijdschr Geneeskd. 2019 Dec 31;164:D4298.[Abstract]
75. Nageotte C, Park M, Havstad S, et al. Duration of airborne Fel d 1 reduction after cat washing. J Allergy Clin Immunol. 2006 Aug;118(2):521-2.[Abstract]
76. Klucka CV, Ownby DR, Green J, et al. Cat shedding of Fel d I is not reduced by washings, Allerpet-C spray, or acepromazine. J Allergy Clin Immunol. 1995 Jun;95(6):1164-71.[Abstract]
77. Sulser C, Schulz G, Wagner P, et al. Can the use of HEPA cleaners in homes of asthmatic children and adolescents sensitized to cat and dog allergens decrease bronchial hyperresponsiveness and allergen contents in solid dust? Int Arch Allergy Immunol. 2009;148(1):23-30.[Abstract]
78. Wood RA, Johnson EF, Van Natta ML, et al. A placebo-controlled trial of a HEPA air cleaner in the treatment of cat allergy. Am J Respir Crit Care Med. 1998 Jul;158(1):115-20.[Abstract]
79. Huss K, Adkinson NF Jr, Eggleston PA, et al. House dust mite and cockroach exposure are strong risk factors for positive allergy skin test responses in the Childhood Asthma Management Program. J Allergy Clin Immunol. 2001 Jan;107(1):48-54.[Abstract]
80. Wood RA, Eggleston PA, Rand C, et al. Cockroach allergen abatement with extermination and sodium hypochlorite cleaning in inner-city homes. Ann Allergy Asthma Immunol. 2001 Jul;87(1):60-4.[Abstract]
81. Bousquet J, Devillier P, Arnavielhe S, et al. Treatment of allergic rhinitis using mobile technology with real-world data: the MASK observational pilot study. Allergy. 2018 Sep;73(9):1763-74.[Abstract][Full Text]
82. Xiao J, Wu WX, Ye YY, et al. A network meta-analysis of randomized controlled trials focusing on different allergic rhinitis medications. Am J Ther. 2016 Nov/Dec;23(6):e1568-78.[Abstract]
83. New Zealand Medicines and Medical Devices Safety Authority (Medsafe). Children and sedating antihistamines. Mar 2013 [internet publication].[Full Text]
84. Blaiss MS. Evolving paradigm in the management of allergic rhinitis-associated ocular symptoms: role of intranasal corticosteroids. Curr Med Res Opin. 2008 Mar;24(3):821-36.[Abstract]
85. Naclerio R. Intranasal corticosteroids reduce ocular symptoms associated with allergic rhinitis. Otolaryngol Head Neck Surg. 2008 Feb;138(2):129-39.[Abstract]
86. Dhami S, Nurmatov U, Arasi S, et al. Allergen immunotherapy for allergic rhinoconjunctivitis: a systematic review and meta-analysis. Allergy. 2017 Nov;72(11):1597-631.[Abstract][Full Text]
87. Radulovic S, Calderon MA, Wilson D, et al. Sublingual immunotherapy for allergic rhinitis. Cochrane Database Syst Rev. 2010 Dec 8;(12):CD002893.[Abstract][Full Text]
88. Jacobsen L, Niggemann B, Dreborg S, et al. Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study. Allergy. 2007 Aug;62(8):943-8.[Abstract]
89. Durham SR, Emminger W, Kapp A, et al. SQ-standardized sublingual grass immunotherapy: confirmation of disease modification 2 years after 3 years of treatment in a randomized trial. J Allergy Clin Immunol. 2012 Mar;129(3):717-25.e5.[Abstract][Full Text]
90. Dretzke J, Meadows A, Novielli N, et al. Subcutaneous and sublingual immunotherapy for seasonal allergic rhinitis: a systematic review and indirect comparison. J Allergy Clin Immunol. 2013 May;131(5):1361-6.[Abstract][Full Text]
91. Lin SY, Erekosima N, Kim JM, et al. Sublingual immunotherapy for the treatment of allergic rhinoconjunctivitis and asthma: a systematic review. JAMA. 2013 Mar 27;309(12):1278-88.[Abstract][Full Text]
92. Durham SR, Creticos PS, Nelson HS, et al. Treatment effect of sublingual immunotherapy tablets and pharmacotherapies for seasonal and perennial allergic rhinitis: pooled analyses. J Allergy Clin Immunol. 2016 Oct;138(4):1081-8.[Abstract][Full Text]
93. Di Bona D, Plaia A, Leto-Barone MS, et al. Efficacy of subcutaneous and sublingual immunotherapy with grass allergens for seasonal allergic rhinitis: a meta-analysis-based comparison. J Allergy Clin Immunol. 2012 Nov;130(5):1097-107.e2.[Abstract]
94. Canonica GW, Cox L, Pawankar R, et al. Sublingual immunotherapy: World Allergy Organization position paper 2013 update. World Allergy Organ J. 2014 Mar 28;7(1):6.[Abstract][Full Text]
95. Calderon MA, Eichel A, Makatsori M, et al. Comparability of subcutaneous and sublingual immunotherapy outcomes in allergic rhinitis clinical trials. Curr Opin Allergy Clin Immunol. 2012 Jun;12(3):249-56.[Abstract]
96. Demoly P, Emminger W, Rehm D, et al. Effective treatment of house dust mite-induced allergic rhinitis with 2 doses of the SQ HDM SLIT-tablet: results from a randomized double-blind, placebo-controlled phase III trial. J Allergy Clin Immunol. 2016 Feb;137(2):444-51.e8.[Abstract][Full Text]
97. Blaiss M, Maloney J, Nolte H, et al. Efficacy and safety of timothy grass allergy immunotherapy tablets in North American children and adolescents. J Allergy Clin Immunol. 2011 Jan;127(1):64-71, 71.e1-4.[Abstract]
98. Durham SR; GT-08 investigators. Sustained effects of grass pollen AIT. Allergy. 2011 Jul;66 (Suppl 95):50-2.[Abstract]
99. Nelson HS, Nolte H, Creticos P, et al. Efficacy and safety of timothy grass allergy immunotherapy tablet treatment in North American adults. J Allergy Clin Immunol. 2011 Jan;127(1):72-80, 80.e1-2.[Abstract]
100. Creticos PS, Esch RE, Couroux P, et al. Randomized, double-blind, placebo-controlled trial of standardized ragweed sublingual-liquid immunotherapy for allergic rhinoconjunctivitis. J Allergy Clin Immunol. 2014 Mar;133(3):751-8.[Abstract][Full Text]
101. Durham SR, Emminger W, Kapp A, et al. Long-term clinical efficacy in grass pollen-induced rhinoconjunctivitis after treatment with SQ-standardized grass allergy immunotherapy tablet. J Allergy Clin Immunol. 2010 Jan;125(1):131-8.e1-7.[Abstract]
102. Walker SM, Pajno GB, Lima MT, et al. Grass pollen immunotherapy for seasonal rhinitis and asthma: a randomized, controlled trial. J Allergy Clin Immunol. 2001 Jan;107(1):87-93.[Abstract]
103. Nacaroglu HT, Erdem SB, Sumer O, et al. Local and systemic reactions to subcutaneous allergen immunotherapy: ten years' experience in a pediatric clinic. Ann Allergy Asthma Immunol. 2016 Apr;116(4):349-53.[Abstract]
104. Gur Cetinkaya P, Kahveci M, Esenboğa S, et al. Systemic and large local reactions during subcutaneous grass pollen immunotherapy in children. Pediatr Allergy Immunol. 2020 Aug;31(6):643-50.[Abstract]
105. Li JT. Immunotherapy for allergic rhinitis. Immunol Allergy Clin North Am. 2000 May;20(2):383-400.[Full Text]
106. Bernstein DI, Wanner M, Borish L, et al. Twelve-year survey of fatal reactions to allergen injections and skin testing: 1990-2001. J Allergy Clin Immunol. 2004 Jun;113(6):1129-36.[Abstract]
107. Greenhawt M, Oppenheimer J, Nelson M, et al. Sublingual immunotherapy: a focused allergen immunotherapy practice parameter update. Ann Allergy Asthma Immunol. 2017 Mar;118(3):276-82.e2.[Abstract][Full Text]
108. Roberts G, Pfaar O, Akdis CA, et al. EAACI Guidelines on allergen immunotherapy: allergic rhinoconjunctivitis. Allergy. 2018 Apr;73(4):765-98.[Abstract][Full Text]
109. Linna O, Kokkonen J, Lukin M. A 10-year prognosis for childhood allergic rhinitis. Acta Paediatr. 1992 Feb;81(2):100-2.[Abstract]
110. Greisner WA III, Settipane RJ, Settipane GA. Natural history of hay fever: a 23-year follow-up of college students. Allergy Asthma Proc. 1998 Sep-Oct;19(5):271-5.[Abstract]
