{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:28:35Z","timestamp":1760984915960,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Allergic rhinitis is one of the most common causes of nasal obstruction, but other diseases need to be considered particularly when the clinical course is getting worse. We present a patient with known mild persistent allergic rhinitis due to house dust mites who experienced progressive worsening of nasal obstruction with associated hyposmia and mucopurulent discharge. The lack of improvement of the patient\u2019s symptoms prompted the re-evaluation of the case. Skin prick tests for airborne allergens confirmed sensitisation only to house dust mites. Nasal endoscopy and facial CT scan revealed a huge rhinolith occupying almost completely the right nasal cavity. The rhinolith was surgically removed with resolution of symptoms. Rhinoliths are rare and unusual calcified materials which grow around intranasal foreign body; they are often promoted by trauma, surgical operations and dental work. The patient underwent dental work about 30\u2005months before the diagnosis of rhinolith, suggesting a possible aetiology.<\/jats:p>","DOI":"10.1136\/bcr-2013-202539","type":"journal-article","created":{"date-parts":[[2014,2,13]],"date-time":"2014-02-13T06:20:33Z","timestamp":1392272433000},"page":"bcr2013202539","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["When perennial rhinitis worsens: rhinolith mimicking severe allergic rhinitis"],"prefix":"10.1136","volume":"2014","author":[{"given":"Enrico","family":"Heffler","sequence":"first","affiliation":[{"name":"Allergy Outpatients\u2019 Clinic, ASL-TO3\u2014Ospedale Civile \u2018Edoardo Agnelli\u2019, Pinerolo, Italy"},{"name":"Department of Medical Sciences, Allergy and Clinical Immunology, University of Torino & AO Ordine Mauriziano, Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giacomo","family":"Machetta","sequence":"additional","affiliation":[{"name":"ENT Department, Ospedale Civile \u2018Edoardo Agnelli\u2019, Pinerolo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Magnano","sequence":"additional","affiliation":[{"name":"ENT Department, Ospedale Civile \u2018Edoardo Agnelli\u2019, Pinerolo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Rolla","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Allergy and Clinical Immunology, University of Torino & AO Ordine Mauriziano, Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,2,13]]},"reference":[{"key":"2025082703281574000_2014.feb13_1.bcr2013202539.1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.4193\/Rhino.11.071","article-title":"The impact of allergic rhinitis on symptoms, and quality of life using the new criterion of ARIA severity classification","volume":"50","author":"Valero","year":"2012","journal-title":"Rhinology"},{"key":"2025082703281574000_2014.feb13_1.bcr2013202539.2","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2013.34.3668"},{"key":"2025082703281574000_2014.feb13_1.bcr2013202539.3","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2013.27.3889"},{"key":"2025082703281574000_2014.feb13_1.bcr2013202539.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2005.02.073"},{"key":"2025082703281574000_2014.feb13_1.bcr2013202539.5","doi-asserted-by":"crossref","unstructured":"Kermanshahi MS Jassar P . A bolt from the blew: rhinolith in the nose for more than 80 years. BMJ Case Rep 2012;2012 . pii: bcr-2012-007322.","DOI":"10.1136\/bcr-2012-007322"},{"key":"2025082703281574000_2014.feb13_1.bcr2013202539.6","doi-asserted-by":"crossref","first-page":"845671","DOI":"10.1155\/2010\/845671","article-title":"The rhinolith-a possible differential diagnosis of a unilateral nasal obstruction","volume":"2010","author":"Brehmer","year":"2010","journal-title":"Case Rep Med"},{"key":"2025082703281574000_2014.feb13_1.bcr2013202539.7","first-page":"601","article-title":"Endoscopy in rhinolithiasis","volume":"22","author":"Ayub-ur-Rehman","year":"2012","journal-title":"J Coll Physicians Surg Pak"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-202539","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:28:22Z","timestamp":1756290502000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-202539"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,2,13]]},"references-count":7,"alternative-id":["10.1136\/bcr-2013-202539"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-202539","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2014,2,13]]}}}