Hay fever is part of the atopy triad – hay fever, asthma, and eczema – and is an allergic reaction to various substances, called allergens. Symptoms include sneezing, nasal itching and runny nose with nasal congestion. Post-nasal drip, itching palate, cough, snoring, and halitosis also occur. Eye symptoms include itching, redness, and watering. In those with asthma, hay fever can also cause chest tightness, breathlessness, cough, and wheeze.
Pollens are the most common allergen. Tree pollens are released, and so cause symptoms, in early to late spring, whereas grass pollens occur late spring to early summer, mould spores in autumn.
House-dust mites are another common allergen in asthma and hay fever – symptoms are worse on waking, occur all year round but peak in spring and autumn. Animal hairs or chemicals will only cause symptoms when exposed.
Allergens prompt a chain of reactions in the blood, releasing various chemicals such as histamine, which affect cells and cause inflammation.
Diagnostic tests
There is no initial diagnostic test for hay fever, doctors simply rely on the clinical picture and trials of self-care and medication. However, tests can be done, especially if symptoms don’t settle. Skin patch testing, previously a useful diagnostic, has generally been replaced by immunological blood tests. These tests can easily be done to show a very wide range of possible allergens, including pollens, house-dust mites and animal dander.
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