Allergic Rhinitis in Children and Adolescents

Schuler, Charles F.; Montejo, Jenny M.

doi:10.1016/j.pcl.2019.06.004

Cited by 104 publications

(89 citation statements)

References 65 publications

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“…The combination of both conditions (rhinitis and asthma) worsens FEV1 and eFeNO values. 2,5 Furthermore, FEV1 and eFeNO had in our patients a negative correlation (Figure 5B), showing that a more severe bronchial obstruction corresponds to a greater degree of airway inflammation.…”

supporting

confidence: 52%

“…4 The inflammation of the nasal mucosa starts as minimal, but it can become persistent after repeated and continuous exposure to aeroallergens. 5 In this case, inflammation seems to increase proportionally to the degree of nasal obstruction, similarly to asthma after the exposure to allergic bronchial triggers. 6,7 Since upper and lower airways represent a continuous entity, a high percentage of AR patients (up to 38%) have also asthma, and the early and correct therapeutic management of both the diseases seems to bring mutual benefits.…”

Section: Introductionmentioning

confidence: 93%

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The Role of Nasal Nitric Oxide and Anterior Active Rhinomanometry in the Diagnosis of Allergic Rhinitis and Asthma: A Message for Pediatric Clinical Practice

Brindisi¹,

Vittori²,

Nola³

et al. 2021

JAA

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Background Allergic rhinitis (AR) and asthma are two common atopic diseases, often associated with a common ethiopathogenesis characterized by a Th2 inflammatory response with the release of many biomarkers, such as nitric oxide (NO). Purpose To evaluate and compare inflammatory (nFeNO and eFeNO) and functional (mNF and FEV1) parameters in AR children with or without asthma in comparison to controls. Secondly, we aimed to identify nFeNO cut-off values and verify their reliability to predict the presence of rhinitis or asthma alone or in combination. Patients and Methods We enrolled 160 children (6–12 years of age) with AR and/or asthma divided into four groups: controls, AR, asthma, and AR + asthma. All children underwent the following inflammatory and functional measurements: nFeNO, eFeNO, mNF and FEV1. Results We observed that levels of nFeNO were extremely higher in children with AR and even more in those with AR + asthma in respect to controls. Notably, all the pathological conditions, especially AR + asthma, showed significantly lower values of mNF compared to healthy children. A negative correlation linked mNF and nFeNO. Then, we found eFeNO values significantly higher in all the pathological groups compared to controls, with major values of this marker in patients affected by asthma and AR + asthma, as well as FEV1 values significantly lower in all the disease groups, especially in children with asthma and AR+ asthma. ROC curve analysis showed that nFeNO was a great predictor for rhinitis alone or with asthma, revealing an accurate cut-off of 662 ppb. Conclusion nFeNO measurement is non-invasive, easy to perform, economic and a valuable test in case of AR alone or in association with asthma. Thus, it should be used in patients with rhinitis, together with anterior active rhinomanometry (AAR) to diagnose and estimate the degree of nasal obstruction but also in children with asthma to assess their nasal involvement and improve the therapeutic management.

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supporting

confidence: 52%

Section: Introductionmentioning

confidence: 93%

The Role of Nasal Nitric Oxide and Anterior Active Rhinomanometry in the Diagnosis of Allergic Rhinitis and Asthma: A Message for Pediatric Clinical Practice

Brindisi¹,

Vittori²,

Nola³

et al. 2021

JAA

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“…Allergic rhinitis is one of the leading causes of olfactory dysfunction and taste disorder. 12–21 In a systematic review of 36 articles about olfaction in AR, the frequency of mild-moderate olfactory dysfunction was found to be in the range of 20% to 40% and its presence increased with the severity of the disease. 20 Rydzewski et al., 17 examined smell and taste functions in 240 patients with AR via olfactometry followed by electrogustometry and found the incidence of smell and taste disorders as 21.4% and 31.2%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…AR is an IgE-mediated inflammation of the nose, characterized by symptoms of sneezing, nasal congestion, itching, and rhinorrhea and signs of clear rhinorrhea and pale discoloration of nasal mucosa. 12,13 It is associated with other allergic diseases, such as conjunctivitis and asthma. It adversely affects sleep, school performance, and quality of life.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Olfactory Function in Children With Vernal Keratoconjunctivitis

Elsürer

Bozkurt

Aksoy

et al. 2020

Am J Rhinol�Allergy

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Background Vernal keratoconjunctivitis (VKC) is a chronic, severe allergic disease of the conjunctiva, which mostly affects young males in early to mid-childhood. There is a high incidence of asthma, allergic rhinitis (AR) and eczema among patients with VKC. It is unknown if VKC patients have abnormal olfactory dysfunction, and if so, whether this is related to AR. Objective Our aim was to evaluate olfactory function in children with VKC, with and without comorbid AR, in comparison to healthy children without VKC. Materials and Methods Thirty-nine VKC patients and 32 healthy children were included in the study. After eye and ear, nose and throat (ENT) examination, acoustic rhinometry and modified Connecticut Chemosensory Clinical Research Center (CCCRC) tests were performed and the test results were compared between VKC and control groups and between VKC children with or without AR. A p value <0.05 was regarded as statistically significant. Results The VKC group included 25 males (64.1%) with a mean age of 11.13 ± 3.22 years, while the control group included 26 males (81.3%) with a mean age of 12.50 ± 2.13 years (p > 0.05 for both age and gender). Fourteen VKC patients (35.9%) had either positive prick test or elevated serum specific IgE levels against house dust mites and pollens. Mean odor thresholds did not differ between the two groups (p = 0.084), while mean odor identification and CCCRC score were statistically significantly lower in VKC group (6.00 ± 1.02 and 6.81 ± 0.75, respectively) compared to control group (7.06 ± 0.77 and 7.5 ± 0.41, respectively) (p < 0.05, both). Thirteen VKC patients had co-associated AR (33.3%). In VKC patients with AR, mean odor threshold and identification scores were even lower (5.31 ± 0.95 and 6.23 ± 0.78, respectively) (p < 0.05, both). Conclusion Olfactory function was found to be mildly impaired in children with VKC, especially when co-associated with AR. Therefore, loss of smell should be asked as an extraocular symptom.

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“…Antagonists of leukotriene receptors block cysteinyl leukotriene receptors, which are important mediators of the inflammatory response in both AR and asthma. 117 Several studies have shown inferiority of LTRA compared with INCs and SGH as therapeutic choices in AR, while as of 03/04/2020, FDA required a boxed warning, based on limited data reporting serious mental health side effects and thus restricting montelukast use for AR. 118…”

Section: Antagonists Of Leukotriene Receptors (Ltra)mentioning

confidence: 99%

New concepts in pediatric rhinitis

Papadopoulos

Aggelides

Stamataki

et al. 2021

Pediatric Allergy Immunology

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Rhinitis-and especially allergic rhinitis (AR)-remains the most frequent hypersensitivity condition, affecting up to a quarter of the population and impacting the quality of life of individual patients and the health economy. Data, especially with respect to underlying pathophysiologic mechanisms, mainly derive from studies on adults and are subsequently extrapolated to the pediatric population. Therapeutic algorithms for children with rhinitis are long based on the same principles as in adults. We explore and describe novel aspects of rhinitis, ranging from mechanisms to disease classification, phenotypes, diagnostic and monitoring tools, and the use of treatments, with a focus on the traits of pediatric age groups.

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Allergic Rhinitis in Children and Adolescents

Cited by 104 publications

References 65 publications

The Role of Nasal Nitric Oxide and Anterior Active Rhinomanometry in the Diagnosis of Allergic Rhinitis and Asthma: A Message for Pediatric Clinical Practice

The Role of Nasal Nitric Oxide and Anterior Active Rhinomanometry in the Diagnosis of Allergic Rhinitis and Asthma: A Message for Pediatric Clinical Practice

Evaluation of Olfactory Function in Children With Vernal Keratoconjunctivitis

New concepts in pediatric rhinitis

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