Abstract
Background:
Evidence demonstrates the existence of local allergic rhinitis (LAR) in nonatopic patients, although its prevalence in the rhinitis population remains unknown in children. The aim of this study was to evaluate the prevalence, clinical characteristics, and severity of LAR in children compared with patients having classical allergic rhinitis (AR) with systemic atopy or nonallergic rhinitis (NAR) with no sensitization to any of the inhaled allergens tested.
Methods:
Two hundred-eighteen children between 9 months and 19 years old
were enrolled and divided into 3 groups: 132 AR children, 68 NAR and 18 healthy
controls. A clinical questionnaire and skin prick test (SPT) were evaluated. A
nasal allergen provocation test (NPT) with Dermatophagoides pteronyssinus was
performed in all subjects. The severity of ocular and nasal symptoms was
recorded by visual analogue scale (VAS) of 10 cm. Each symptom was categorized
as 'mild' (VAS: 0–3 cm), 'moderate' (VAS: >3–7 cm), or 'severe' (VAS > 7
cm).
Results:
In the AR group, 43/132 (32.6%) patients presented a positive
response to NPT. In the NAR group, 11/69 (15.9%) patients had a positive
response to NPT. NPT was negative in 17/18 healthy controls (94.4%). The
majority of rhinitis patients had moderate–severe nasal symptoms. LAR and AR
subjects had a similar pattern of nasal symptoms in frequency and severity.
However, significant differences were detected between LAR and NAR.
Conclusion:
Local allergic rhinitis is a prevalent entity in patients
evaluated with rhinitis. LAR and AR subjects had a similar pattern of nasal
symptoms in frequency and severity. Conventional skin tests were
significantly well correlated with nasal provocation tests.
Key Words: Local allergic rhinitis, Nasal provocation test, Children