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Nonallergic rhinitis in children
William E Berger1, J Ellen Schonfeld
1Allergy and Asthma Associates of Southern California, 27800 Medical Center Road, Suite 244, Mission Viejo, CA 92691, USA.
Insights
Pediatric nonallergic rhinitis lacks clear definition and treatment guidelines. Laryngopharyngeal reflux (LPR) may be a key factor in children with chronic rhinitis and related conditions.
Area of Science:
- Pediatric Otolaryngology
- Allergy and Immunology
Background:
- Nonallergic rhinitis in children is poorly defined, with unknown incidence and treatment based on adult data.
- The underlying mechanisms of pediatric nonallergic rhinitis remain unclear.
- Laryngopharyngeal reflux (LPR) is under investigation for its role in upper airway diseases.
Purpose of the Study:
- To explore the potential role of LPR in pediatric nonallergic rhinitis.
- To highlight LPR as a differential diagnosis for children with chronic rhinitis and negative allergy tests.
Main Methods:
- Review of current understanding of LPR and its association with upper airway conditions.
- Clinical consideration of LPR in the differential diagnosis of pediatric rhinitis.
Main Results:
- Substantial evidence links LPR to rhinitis, sinus disease, and middle ear disease.
- LPR is a potential contributor to pediatric nonallergic rhinitis.
Conclusions:
- LPR should be considered in the differential diagnosis of nonallergic rhinitis in children, especially those with chronic rhinitis and negative allergy tests.
- Clinicians should consider LPR in children with recurrent comorbidities like chronic sinusitis or persistent middle ear disease.
Abstract:
Nonallergic rhinitis in children is a medical condition that has not been well defined and the true incidence is unknown. Current treatment recommendations are based on data obtained from adult studies. The mechanisms of pediatric nonallergic rhinitis are also unclear. The concept that laryngopharyngeal reflux (LPR) events may play a critical role in the pathogenesis of upper airway disease is presently under investigation. Although LPR is being better delineated and appropriate methods of diagnosis and treatment are being studied, substantial evidence links LPR with several disease states including rhinitis, sinus disease, and middle ear disease. Due to the lack of information concerning the etiology of nonallergic rhinitis in children, LPR should be considered in the differential diagnosis of a child with negative skin tests and chronic rhinitis symptoms. The clinician should especially give attention to this diagnosis when a child presents with recurrent co-morbid conditions such as chronic sinusitis or persistent middle ear disease.
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