Diagnosis of Allergic Rhinitis

 
Physical Examination
Children:
In children, physical examination may reveal dark circles under the eyes (allergic shiners), a transverse nasal crease caused by repeated rubbing of the nose, adenoidal breathing, edematous nasal turbinates coated with clear secretions, tearing and edema, and periorbital swelling.
Adults:
Physical findings as mentioned in children are generally less obvious in adults.

Microscopic examination
Microscopic examination of nasal scrapings typically reveals numerous eosinophils. The peripheral blood eosinophil count may be elevated, but it is nonspecific and has limited usefulness.

Allergy testing
Allergy testing can help to determine whether rhinitis is caused by an immune response to allergens. Immediate-type hypersensitivity skin tests are commonly used. Percutaneous testing is safer and more generally accepted than intradermal testing, which is usually reserved for patients requiring confirmation. The radioallergosorbent test (RAST) can be used to detect IgE antibodies in the blood that are specific for a given antigen, but it is less sensitive than percutaneous tests.