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This protocol has been proven safe and useful to differentiate between children and adolescents with AR and controls. Concentrations of 1:1000 and 1:100 D. pteronyssinus were the best for use in simplified specific NPT, which made it simpler and faster, and expanded its clinical applicability.

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Objectives: To standardize acoustic rhinometry (AR) in nasal provocation tests (NPTs) with histamine in children and adolescents. Patients and Methods: We performed a cross-sectional validation to compare AR with anterior active rhinomanometry (AAR) during histamine NPT in 20 children and adolescents with persistent allergic rhinitis and 20 controls. Changes in total nasal resistance (AAR) were compared with changes in nasal volume in the first 5 cm (V5 ; P=.04) at baseline. The mean histamine concentration necessary to increase total nasal resistance by at least 100% was significantly lower in the rhinitis group than in the control group (0.72 mg/mL vs 2.4 mg/mL; P<.001). At the end of the NPT a mean increase of 126% in total nasal resistance and a mean decrease of 24.3% in V5 were observed in the rhinitis group. When compared with the AAR criteria, the highest sensitivity and specificity values were observed for a cutoff represented by a 19%-21% drop in V5. Conclusions: We found AR to be a feasible and sensitive tool for monitoring nasal response in children and adolescents undergoing histamine NPT. The best AR cutoff for ending the NPT was a 19%-21% drop in V5. Key words: Rhinitis. Nasal provocation tests. Histamine. Acoustic rhinometry. Rhinomanometry. Nasal cavity. Airway resistance. ResumenObjetivos: Estandarizar la rinometría acústica (RA) como medida de la respuesta a la prueba de provocación nasal con histamina (PPN) en niños y adolescentes. Pacientes y métodos: Se realizó un estudio de validación transversal comparando la RA frente a la rinomanometría anterior (RAA) activa en la evaluación de la respuesta frente a la PPN con histamina, realizado en 20 niños o adolescentes, diagnosticados de rinitis alérgica persistente y 20 controles sanos. Las variables estudiadas fueron los cambios en la resistencia nasal total, medida mediante RAA y los cambios en el volumen nasal de los primeros 5 cm (V5) evaluados mediante RA. Resultados: En relación con los sujetos control, los pacientes con rinitis alérgica presentaban niveles basales de resistencia nasal total significativamente más elevados (medias respectivas 0,34 Pa/cm 3 /s versus 0,21 Pa/cm 3 /s; p= 0,01) y valores de V5 significativamente inferiores (medias respectivas 8,20 cm 3 versus 9,24 cm 3 ; p= 0,04). La concentración media de histamina necesaria para incrementar el 100% la resistencia total nasal fue significativamente más baja en los pacientes con rinitis que en los controles (medias respectivas 0,72 mg/ml versus 2,4 mg/ml; p< 0,001). Al final de la PPN el incremento medio de la resistencia nasal total fue del 126%, en los sujetos con rinitis alérgica. En ese momento también se observó en este grupo un decremento medio del V5 del 24,3%. Utilizando como patrón oro de respuesta positiva un incremento en la resistencia nasal total del 100% mediante RAA, los puntos de corte con mayor sensibilidad y especificidad para el descenso de V5 se encontraban en un descenso de entre el 19 y 21%. Conclusiones: Nuestros resultados demuestran que la RA es ...

The Brazilian Portuguese version of the RCAT was shown to be a valid and discriminant tool to identify patients with controlled and uncontrolled allergic rhinitis.

Background: Local allergic rhinitis (LAR) is a well-defined and reported phenotype in adults, but data is scarce for children and adolescents, and it is probably an undiagnosed and highly underestimated condition in childhood. Objectives: The objectives of this systematic review were to identify original observational studies published on LAR in children and adolescents and to describe the prevalence and characteristics of this phenotype in the pediatric age group. Methods: A systematic search was performed in PubMed and EMBASE databases. The search was limited to publications on humans, written in English, published between January 1, 2000 and September 20, 2021. Participants had to be under 18 years old and with a diagnosis of LAR confirmed by nasal allergen provocation test (NAPT). Results: Ten articles were identified. Despite the wide variability of protocols, prevalence rates ranged from 3.7 to 83.3% among children previously diagnosed as having nonallergic rhinitis, being markedly lower in Eastern countries (3.7–16.6%) when compared to Western countries (22.3–83.3%). To date, no relevant clinical characteristics capable of differentiating LAR patients from other childhood rhinitis phenotypes have been identified. Conclusions: LAR is an allergic rhinitis phenotype also found in children. Population and regional differences and differences in NAPT protocols may explain the heterogeneity in LAR prevalence rates observed in different parts of the world. In addition to clarifying this large discrepancy, longitudinal studies are also needed to assess the clinical characteristics of the LAR phenotype in the pediatric age group, and its stability into adulthood must be confirmed.

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A alergia ocular, também conhecida como conjuntivite alérgica (CA), é uma reação de hipersensibilidade mediada por imunoglobulina E (IgE) do olho desencadeada por aeroalérgenos, principalmente ácaros da poeira doméstica e pólen de gramíneas. Os sintomas geralmente consistem em prurido ocular ou periocular, lacrimejamento e olhos vermelhos que podem estar presentes durante todo o ano ou sazonalmente. A alergia ocular tem frequência elevada, é subdiagnosticada e pode ser debilitante para o paciente. É potencialmente danosa para a visão, nos casos em que ocasiona cicatrização corneana grave, e na maioria dos pacientes associa-se a outros quadros alérgicos, principalmente rinite, asma e dermatite atópica. É classificada em conjuntivite alérgica perene, conjuntivite alérgica sazonal, ceratoconjuntivite atópica e ceratoconjuntivite vernal. O diagnóstico procura evidenciar o agente etiológico e a confirmação se dá pela realização do teste de provocação conjuntival. O tratamento baseia-se em evitar o contato com os desencadeantes, lubrificação, anti-histamínicos tópicos, estabilizadores de mastócitos, imunossupressores e imunoterapia específica com o objetivo de obter o controle e prevenir as complicações da doença.Descritores: Alergia ocular, conjuntivite alérgica, rinoconjuntivite.Ocular allergy, also known as allergic conjunctivitis, is an immunoglobulin E-mediated hypersensitivity reaction of the eye triggered by airborne allergens, primarily house dust mites and grass pollen. Symptoms usually consist of ocular or periocular itching, watery eyes, and red eyes that may be present year-round or seasonally. Ocular allergy has a high frequency, is underdiagnosed, and can be debilitating for the patient. It is potentially harmful to vision in cases of severe corneal scarring, and in most patients, it is associated with other allergic conditions, especially rhinitis, asthma, and atopic dermatitis. It is classified as perennial allergic conjunctivitis, seasonal allergic conjunctivitis, atopic keratoconjunctivitis, and vernal keratoconjunctivitis. Diagnosis seeks to identify the etiologic agent, and confirmation is given by conjunctival provocation testing. Treatment is based on avoiding contact with triggers, lubrication, topical antihistamines, mast cell stabilizers, immunosuppressants, and specific immunotherapy with the aim of achieving control and preventing disease complications.