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Chronic rhinitis in the pre-school child
Insights
This study investigated atopy in chronic rhinitis for young children. Promethazine effectively controlled symptoms with minimal side effects, showing promise for treating allergic rhinitis in preschoolers.
Area of Science:
- Pediatric Allergy and Immunology
- Otolaryngology
Background:
- Chronic rhinitis is a common condition in infants and preschool children.
- The role of atopy (allergic predisposition) in pediatric rhinitis requires further investigation.
- Long-term treatment options for chronic rhinitis in young children are limited.
Purpose of the Study:
- To investigate the etiologic role of atopy in chronic rhinitis in infants and preschool children.
- To evaluate the long-term effectiveness and safety of promethazine for managing chronic rhinitis symptoms in this age group.
Main Methods:
- A cohort of 40 infants and preschool children with chronic rhinitis was studied.
- Participants underwent clinical evaluation, skin prick tests for common allergens, RAST tests, total IgE level assessment, and absolute eosinophil counts.
- Promethazine was administered at doses of 3-12 mg/kg/day for perennial, recurrent, or seasonal rhinitis.
Main Results:
- Twenty children showed clear evidence of atopy, while 16 did not; four had incomplete laboratory findings.
- Promethazine demonstrated effectiveness in controlling rhinitis symptoms.
- The primary side effects observed were drowsiness and irritability, leading to discontinuation in one patient. No hematologic, renal, or hepatic abnormalities were detected.
Conclusions:
- Atopy plays a significant role in the etiology of chronic rhinitis in young children.
- Promethazine is an effective and safe option for symptom management of chronic rhinitis in the preschool population.
- Further research can explore long-term outcomes and optimal dosing strategies for promethazine in pediatric rhinitis.
Abstract:
The etiologic role of atopy in chronic rhinitis in 40 infants and pre-school children was investigated and the long-term effectiveness and safety of promethazine studied during six to 48 months. Twenty children were clearly atopic and 16 were not. Four had incomplete laboratory evidence of atopy. In addition to clinical histories and physical findings, the subjects were evaluated by skin tests for common allergens. RAST tests, total IgE levels and absolute eosinophil counts. Promethazine in doses of 3 to 12 mg/kg/day (mean 8 mg) was administered in divided doses, four times a day for perennial rhinitis and on "as required" basis for recurrent and seasonal rhinitis. Side effects included drowsiness and irritability, which led to discontinuance of promethazine in one subject. There was no laboratory evidence of hematologic, renal or hepatic abnormalities. Promethazine was found to be an effective agent for symptom-control of chronic rhinitis in the pre-school child.