Differential Diagnosis

The patient's symptoms of runny nose, watery eyes, sneezing, swollen nasal turbinates, and mild swelling and erythema of the conjunctiva can be attributed to various causes. Here's a categorized differential diagnosis:

• Single Most Likely Diagnosis

  • Allergic Rhinitis: This is the most likely cause given the patient's symptoms of runny nose, watery eyes, sneezing, and swollen nasal turbinates. The recent move into an older apartment building could expose her to new allergens such as dust mites, mold, or pet dander from previous occupants. The constant use of air conditioning could also circulate these allergens, exacerbating her symptoms.

• Other Likely Diagnoses

  • Vasomotor Rhinitis: This non-allergic condition could be triggered by the dry air from the air conditioning, leading to similar symptoms of runny nose and sneezing.
  • Environmental Irritant Rhinitis: Exposure to irritants such as strong odors, chemicals, or pollution in the new apartment building could cause her symptoms.
  • Sinusitis: Given the duration of her symptoms, sinusitis (either acute or chronic) could be a consideration, especially if there's an underlying infection or anatomical issue.

• Do Not Miss Diagnoses

  • Anaphylaxis: Although less likely given the chronic nature of her symptoms, it's crucial to consider anaphylaxis, especially if she experiences any symptoms of a severe allergic reaction such as difficulty breathing, rapid heartbeat, or a drop in blood pressure.
  • Angioedema: This condition, which can cause swelling of the face, lips, tongue, or throat, could be life-threatening if not promptly treated.

• Rare Diagnoses

  • Granulomatosis with Polyangiitis (GPA): A rare autoimmune disorder that could cause chronic sinusitis and rhinitis, among other symptoms.
  • Sjögren's Syndrome: An autoimmune disorder that could lead to dry eyes and other mucosal symptoms, though it typically presents with more systemic symptoms.
  • Eosinophilic Esophagitis or Gastroesophageal Reflux Disease (GERD) with laryngopharyngeal reflux: Though less directly related to her primary symptoms, these conditions could potentially cause or contribute to chronic cough or throat clearing, which might be mistaken for or accompany her current symptoms.