ABSTRACT
When avoidance measures and medications are unsuccessful, immunotherapy may be appropriate. Perennial allergic rhinitis that responds poorly to medical therapy and avoidance may require immunotherapy. Patients who have tried both antihistamines and topical therapy and who have failed either because of lack of response or adverse effects may benefit from immunotherapy. Frequently, too little attention is paid to quality-of-life issues, such as the effect of allergic rhinitis on physical activity, intellectual performance, emotional interaction and social relationships. Poor performance at school and at work can clearly be traced to an intensification of these allergic conditions (Table 10.1).
