NHG-Standaard
M48
3.0
januari 2018
januari 2018
R. Luchtwegen

Richtlijnen diagnostiek

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Lichamelijk onderzoek

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Aanvullend onderzoek

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Richtlijnen beleid

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Niet-medicamenteuze behandeling

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Medicamenteuze behandeling

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Consultatie en verwijzing

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Belangrijkste wijzigingen

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Kernboodschappen

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Achtergronden

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Allergische rinitis

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Niet-allergische rinitis

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Orale-allergiesyndroom

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Epidemiologie

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Incidentie en prevalentie

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Onderrapportage

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Risicofactor voor astma

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Pathofysiologie

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Allergische rinitis

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Vroegefasereactie
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Latefasereactie
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Hyperreactiviteit en priming
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Belangrijkste allergenen
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Niet-allergische rinitis

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Belangrijkste subtypen
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Hyperreactiviteit
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Overige diagnoses

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Sinusgerelateerde aandoeningen

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Richtlijnen diagnostiek

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Ontstaan en verergering van klachten

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Lichamelijk onderzoek

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Andere oorzaken uitsluiten

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Aanvullend onderzoek

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Graspollen- of boompollenallergie
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Bloedonderzoek op inhalatieallergenen
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Specifieke IgE-bepaling
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Allergeenspecifieke IgE-bepaling
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Concentratiespecifieke IgE-bepaling
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Beoordeling in context van klachten
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Huispriktest versus allergeenspecifieke IgE-bepaling
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Allergische rinitis

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Niet-allergische rinitis

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Werkgerelateerde rinitis

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Richtlijnen beleid allergische rinitis

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Voorlichting

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Niet-medicamenteuze behandeling

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Prikkels vermijden en stoppen met roken

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Neusdruppels met fysiologisch zout

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Pollenallergie

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Huisstofmijtallergie

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Allergie voor huisdieren

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Medicamenteuze behandeling

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Keuze medicamenteuze behandeling

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Oudere sederende antihistaminica

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Keuze geneesmiddel

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Voorkeursmiddelen
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Voorlichting
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Allergische oogklachten

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Kortademigheid en piepen

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Zwangerschap en borstvoeding

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Neusspray en systemische behandeling
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Bijwerkingen

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Overige medicatie bij allergische rinitis

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Cromoglicinezuur
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Montelukast
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Oraal of intramusculair toegediende corticosteroïden
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Sublinguale immunotherapie
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Subcutane immunotherapie
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Subcutane immunotherapie
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Medicamenteuze behandeling anafylaxie bij volwassenen
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Combinatiepreparaat (azelastine/fluticason)
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Richtlijnen beleid niet-allergische rinitis

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Voorlichting

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Medicamenteuze rinitis

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Rinitis door decongestiva

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Corticosteroïdneusspray bij rinitis door decongestiva
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Rinitis door geneesmiddelen

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Overige oorzaken

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Idiopathische rinitis: azelastineneusspray
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Idiopathische rinitis: nasale corticosteroïden
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Idiopathische rinitis: ipratropiumbromide
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Rinitis bij ouderen
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Rinitis door roken
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Rinitis door zwangerschap
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Conchahypertrofie
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Consultatie en verwijzing

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Operatieve behandeling
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Kno-arts, allergoloog of kinderallergoloog/-arts

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Allergoloog

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Bedrijfsarts

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Referenties

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NHG-werkgroep:
Aalberse J, Fokkens W, Lucassen P, Sijbom M, Van Sleeuwen D, Wiersma T, Zegers R
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