title: Extranasal symptoms of allergic rhinitis are difficult to treat and affect quality of life.
abstract: BACKGROUND
  Total nasal symptom score is widely used to evaluate the severity of allergic rhinitis, but the clinical significance of extranasal symptoms is largely unknown. We wished to analyze the presenting symptoms in allergic rhinitis, as well as their relationship with quality of life (QoL) and therapeutic outcomes.
  
  
  METHODS
  Presenting symptoms and QoL were assessed using the Optum™ SF-12v2(®) Health Survey in 260 patients with allergic rhinitis. Clinical response at 3 months after treatment was measured.
  
  
  RESULTS
  Ten most common symptoms presenting with at least moderate severity in allergic rhinitis were: blocked nose (82.7%), rhinorrhea (75.0%), sneeze (70.9%), itchy nose (68.5%), fatigue (63.6%), mouth breathing (61.1%), daytime somnolence (52.7%), postnasal drip (49.1%), itchy eyes (47.3%), and dry mouth (46.3%). Severity of sneeze was correlated with physical component summary (PCS) whereas postnasal drip and daytime somnolence were correlated with mental component summary (MCS). Severity of dry mouth was correlated with PCS and MCS. The symptoms with the highest severity scores after treatment were blocked nose, postnasal drip, fatigue, and dry mouth, respectively.
  
  
  CONCLUSIONS
  Extranasal symptom scores correlated well with physical health and mental health in allergic rhinitis patients. Assessment of extranasal symptoms should be included to evaluate disease severity and assess therapeutic outcomes. Clinical trial NCT02000648, http://www.clinicaltrials.gov.
authors.affiliation: Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Veeravich
authors.initials: V
authors.lastname: Jaruvongvanich
authors.affiliation: King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
authors.forename: Pungjai
authors.initials: P
authors.lastname: Mongkolpathumrat
authors.affiliation: King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Allergy and Clinical Immunology Research group, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Chantaphakul
authors.affiliation: King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Allergy and Clinical Immunology Research group, Chulalongkorn University, Bangkok, Thailand. Electronic address: Jettanong.K@chula.ac.th.
authors.forename: Jettanong
authors.initials: J
authors.lastname: Klaewsongkram
mesh_terms: D000328:Adult; D000818:Animals; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011788:Quality of Life; D065631:Rhinitis, Allergic / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D012720:Severity of Illness Index; D012882:Skin Tests; D016896:Treatment Outcome
keywords: Allergic rhinitis; Perennial allergic rhinitis; Quality of life; Self-assessment; Skin test