Laryngeal allergy

Many patients with allergic rhinitis have accompanying laryngeal symptoms such as persistent cough and/or globus. Chronic laryngeal allergy is suspected to be an important cause of these laryngeal symptoms. We have been working toward establishing the concept of a new pathological condition termed “laryngeal allergy” since 1988. In Japan, the first diagnostic criteria for laryngeal allergy were established in 1995. However, these early criteria were inadequate because there was inadequate distinction between laryngeal allergy and other causes of persistent cough and globus. Therefore, more advanced criteria were reconstructed from a completely different viewpoint in 2005 to correctly distinguish laryngeal allergy from other similar diseases. The criteria established in 2005 were modified slightly in 2011 to improve the diagnostic accuracy based on the results of fundamental and clinical investigations. The Japanese Respiratory Society (JRS) included chronic laryngeal allergy in the diagnostic flowchart of the JRS guidelines for the management of cough and sputum in 2019, and chronic laryngeal allergy has recently gained wider recognition in Japan. The accurate diagnosis of conditions resembling laryngeal allergy is important in controlling cough and/or globus and preventing the unnecessary use of medical resources. Therefore, further investigations are warranted to better understand laryngeal allergy and similar diseases.