[Research progress on rhinitis medicamentosa]

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Nov 7;52(11):872-875. doi: 10.3760/cma.j.issn.1673-0860.2017.11.019.
[Article in Chinese]

Abstract

Rhinitis medicamentosa (RM) refers to nonallergic inflammation in the nasal mucosa which is caused by the abuse of nasal decongestant and it often occurs in patients with allergic/nonallergic rhinitis along with nasal congestion. RM is characterized by nasal congestion based on long-term use of nasal decongestant, without rhinorrhoea or sneezing. The signs of RM include nasal swelling, thickening, loss of elasticity, and loss of sensitivity to the decongestant. The histological changes of RM are loss of nasal mucosa cilia, squamous epithelium metaplasia, edema of epithelium cell, hyperplasia of goblet cell, increased expression of epidermal growth factor receptor and infiltration of inflammatory cells, etc. There is no precise diagnosis standard for RM, making it even harder for its objective diagnosis. Patients with RM should immediately stop using nasal decongestant, in stead of using nasal glucocorticoid spray for the recovery of the nasal mucosa's function.

药物性鼻炎是指长期、过量应用鼻部减充血剂导致的鼻黏膜非变应性炎性反应,常发生于伴有鼻塞症状的鼻炎患者。在长期使用鼻减充血剂的基础上出现鼻塞症状为该病的主要特征,不包含流涕、喷嚏等。体征为鼻黏膜红肿、增厚、失去弹性、对减充血剂不再敏感。组织病理学变化主要包括鼻黏膜纤毛缺失、鳞状上皮化生、上皮水肿、上皮细胞裸露、杯状细胞增生以及炎性细胞浸润等,目前尚缺乏统一的诊断标准。治疗上主要为停用鼻部减充血剂及使用鼻喷糖皮质激素。.

Keywords: Glucocorticoids; Nasal decongestants; Nasal obstruction; Rhinitis medicamentosa.

MeSH terms

  • Chronic Disease
  • Cilia / drug effects
  • Edema / chemically induced
  • ErbB Receptors / metabolism
  • Glucocorticoids / therapeutic use
  • Humans
  • Hyperplasia / chemically induced
  • Hyperplasia / pathology
  • Nasal Decongestants / adverse effects*
  • Nasal Mucosa / drug effects
  • Nasal Mucosa / pathology
  • Research
  • Rhinitis / chemically induced*
  • Rhinitis / pathology

Substances

  • Glucocorticoids
  • Nasal Decongestants
  • EGFR protein, human
  • ErbB Receptors