الفهرس 
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Abstract
Allergic rhinitis represents a global health problem affecting 10% to 20% of the population. Allergic rhinitis (AR) is the most common immunological disorder and is characterized by an immunoglobulin E (IgE)-mediated inflammation induced by the allergen exposure. Even though not a serious illness, may be a clinically relevant disorder as it may present numerous complications and affect quality of life. Therefore, the management of AR patients should be rigorously careful and multi-disciplinary.
Food allergy is one of the most common causes of systematic anaphylaxis and anaphylactoid reactions, with an annual incidence of four cases per million populations and estimated 500 deaths annually. Food is the leading cause among identified triggers of anaphylaxis in children and young adults outside of the hospital setting. The true prevalence of IgE-mediated food allergy in the population with respiratory allergy is unknown. The present study was undertaken to identify the prevalence of IgE-mediated food allergy and allergens in the adolescent and adult population with allergic rhinitis.
This study was conducted on 150 patients over one year from (Augest 2010) to (August 2011). The selected patients were recruited from the Allergy and Clinical immunology outpatient clinic at Ain Shams University Hospitals.
All patients were subjected to: Full medical history taking, Clinical examination, Skin prick test, Serum total IgE by ELISA.
We observed from this study:
The prevalence of food allergy in this study was estimated to be 26% among patients with allergic rhinitis. Various foods have been implicated as trigger factors in different geographical regions but in the present study, strawberry and egg were found to be the most prevalent food allergies in adult patients with allergic rhinitis.
Only of 31.3% with allergic rhinitis patients showed skin reactivity to aeroallergens. The most common aeroallergen detected among our studied patients with allergic rhinitis was HDM 50%.
The association of other forms of atopic diseases among patients with allergic rhinitis through co-existing symptoms have been evaluated The allergic conjunctivitis (30 %) was the most common accompanying allergic disease among 36.7 % patients who had at least one accompanying allergic disease.
The patients with allergic rhinitis in this work were categorized as regard level of severity according to ARIA classification into 4 groups, (59%) of patients had intermittent symptoms, others had mild persistent symptoms, while some patients had moderate persistent symptoms and the least had severe persistent symptoms.
Despite these results, the use of IgE as a measurement of allergic disorders has its limitations and cannot replace a careful history for diagnosis, especially for non-IgE mediated allergies. Only 48% of patients with rhinitis exhibited high total serum IgE level in the present study.
In our study, we found that 22% of adults perceived that they had food allergy, whereas only 6.7% of adults had probable IgE mediated food allergy.
We observed that positive SPT reaction to food with coexisting outdoor and other indoor allergens was observed in 38.2% patients with allergic rhinitis.
Food allergy sensitisation was comparable among those with positive and negative SPT reactivity to food allergens as regards clinical characteristic with no significant association.
In conclusion the prevalence of probable IgE-mediated food reactions are indeed rare in young adults. The prevalence of food allergy was estimated to be 26% among patients with allergic rhinitis. Food allergy affects family, social activities, stress level, meal preparation, school attendance and activity scores.
History and allergen spectrum of patients should carefully be evaluated in order to determine the risk factors for developing food allergy in patients with allergic rhinitis.