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Clinical characteristics of children with non-allergic rhinitis vs with allergic rhinitis

Pakit Vichyanond¹, Chanthana Suratannon, Piyarat Lertbunnaphong

¹Division of Allergy and Clinical Immunology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand. pakitv@gmail.com

Asian Pacific Journal of Allergy and Immunology

|February 23, 2011

Insights

Children with allergic rhinitis (AR) often experience nasal itching, sneezing, and eye symptoms. Nonallergic rhinitis (NAR) in children is linked to snoring and sinusitis, with an earlier onset than AR.

Area of Science:

Pediatric Allergy and Immunology
Otorhinolaryngology
Clinical Rhinology

Background:

Allergic rhinitis (AR) and nonallergic rhinitis (NAR) are leading causes of chronic rhinitis in children.
Limited data exists on the clinical distinctions of NAR in pediatric populations.

Purpose of the Study:

To delineate the clinical characteristics differentiating NAR from AR in children presenting with chronic rhinitis.
To identify specific symptoms associated with each type of rhinitis in pediatric patients.

Main Methods:

Retrospective descriptive study of 302 children (≤14 years) with chronic rhinitis.
Classification into AR and NAR groups based on skin prick testing (SPT).
Review of medical records for rhinitis-related clinical data and symptoms.

Main Results:

AR was diagnosed in 73.5% and NAR in 26.5% of patients.
NAR showed a younger age of onset (p=0.04) and shorter disease duration compared to AR.
Nasal pruritus, sneezing, and eye symptoms were significantly more frequent in AR (p<0.01), while snoring and sinusitis were more common in NAR (p<0.01).

Conclusions:

Nasal pruritus, sneezing, and eye symptoms are indicative of AR in children.
Sinusitis and upper airway obstruction (snoring) are more prevalent in pediatric patients with NAR.

Read full analysis

Abstract

Background:

Allergic rhinitis (AR) and nonallergic rhinitis (NAR) are major causes of chronic rhinitis. Knowledge about children with non-allergic rhinitis is limited.

Objective:

To study clinical characteristics differentiating NAR and AR among children with chronic rhinitis.

Methods:

This is a retrospective, descriptive study of 302 children (with ages of 14 years or less) with chronic rhinitis evaluated at the pediatric allergy clinic, Siriraj Hospital between January and December 2006. Based on the results of skin prick test (SPT), they were classified into 2 groups, i.e., AR and NAR. Their medical records were reviewed with respect to clinical data on rhinitis and related symptoms.

Results:

There were 222 patients with AR and 80 with NAR (73.5% and 26.5%). Median age of onset of the disease among patients with NAR was younger than AR (p = 0.04) while the duration of disease among AR cases was longer than in NAR (p < 0.01). Severity of rhinitis, based on Allergic Rhinitis and its Impact on Asthma (ARIA), was not different between the two groups. Nasal pruritus, sneezing and eye symptoms were more commonly observed in AR than in NAR (p < 0.01), whereas snoring and sinusitis were more common in NAR than in AR (p < 0.01). The presence of nasal pruritus, sneezing and eye symptoms strongly suggested AR (adjusted OR 2.73, 2.96, 1.49) while snoring was a risk factor for NAR (adjusted OR = 3.11).

Conclusion:

Presence of nasal pruritus, sneezing and eye symptoms suggests AR. Sinusitis and upper airway obstruction are more common among patients with NAR.

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