Related Experiment Video
Updated: Aug 10, 2026
Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
Allergic rhinitis and recurrent epistaxis in children
1University of British Columbia, B.C.'s Children's Hospital, Vancouver, Canada.
Insights
Allergic rhinitis is linked to recurrent nosebleeds in children. Nasal symptoms combined with allergies significantly increase the risk of epistaxis, suggesting an underlying hemostatic disorder in atopic individuals.
Area of Science:
- Pediatric Allergy and Immunology
- Otolaryngology
- Allergic Rhinitis Research
Background:
- Allergic rhinitis is often overlooked as a cause of childhood nosebleeds by otolaryngologists compared to allergists.
- Investigating the connection between allergic rhinitis and epistaxis in pediatric populations is crucial.
Purpose of the Study:
- To determine the relationship between allergic rhinitis and epistaxis in children.
- To ascertain if nasal symptoms alone can cause recurrent nosebleeds.
Main Methods:
- A consecutive series of 557 children referred to a pediatric allergy clinic were studied.
- Standardized parental questionnaires and skin prick tests for common inhalant allergens were employed.
Main Results:
- Children with both nasal symptoms and positive skin tests had a 20.2% rate of recurrent nosebleeds, significantly higher than other groups.
- Logistic regression showed an odds ratio of 3.3 for nosebleeds in children with both allergic rhinitis symptoms and positive skin tests.
- Pet ownership combined with specific allergies (e.g., to dogs or cats) further increased the incidence of nosebleeds.
Conclusions:
- Allergic rhinitis is frequently associated with recurrent epistaxis in children.
- Nasal symptoms in allergic children, possibly combined with an atopic-related hemostatic abnormality, contribute to nosebleeds.
- A disorder of hemostasis is suspected as a contributing factor to epistaxis in children with allergic rhinitis.
Background:
Many allergists, but few otolaryngologists, consider allergic rhinitis to be a common cause of nosebleeds in childhood.
Objective:
To determine whether the two conditions are related, and whether epistaxis could be due solely to the local effects of nasal symptoms.
Methods:
We studied 557 children who were referred consecutively to an allergy clinic of a children's hospital. Standardized questions were put to their accompanying parents, and skin prick tests were performed on the children, using common local inhalant allergens.
Results:
On univariate analysis children who had both nasal symptoms and a positive skin test were found to have recurrent nosebleeds more frequently (20.2%) than had those with nasal symptoms on their own (9.9%), a positive skin test alone (3.4%), or neither (2.1%). Similarly, on logistic regression the odds ratio (OR) of nosebleeds was 3.3, 1.3, 1.65, and 1, respectively. Nosebleeds were more common in those who owned a dog or a cat and had a positive skin test to that species than in the remainder of the children (27.8% vs 10.8%).
Conclusions:
Allergic rhinitis is commonly associated with recurrent epistaxis. In many children it appears that nosebleeds are due to nasal symptoms plus some abnormality that is found in the atopic state: a disorder of hemostasis is suspected as the contributing factor.
Related Concept Videos
02:06Allergic Reactions
01:16Drugs Used in Upper Respiratory Disorders: Overview
Antihistamines (e.g., Benadryl) block histamines from binding. Histamines are chemicals released during an allergic reaction in the body. As a...
01:30Epistaxis
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
01:29Asthma-I: Introduction
01:30Allergic Reactions: Anaphylaxis
01:28Asthma I: Introduction