Abstract
BackgroundIn the preschool period, allergic rhinitis (AR) is infrequent and thus under-diagnosed. However, recent works have highlighted the occurrence of AR in toddlers although the causes of AR in this young population remain unknown. The objective of this study was to identify determinants of AR in young children with asthma.MethodsWe carried out a case-control study of 227 children with active asthma and enrolled in the Trousseau Asthma Program. AR and other allergic diseases (asthma, food allergy and eczema) were diagnosed by medical doctors using standardized questionnaires. Parental history of AR and asthma, biological markers of atopy (total IgE, blood eosinophilia, allergic sensitization towards food and aeroallergens) and environmental parameters were also collected.ResultsForty one of the children (18.1%) had AR. By univariate logistic regression analysis, AR was mainly associated with peanut sensitization (OR = 6.75; p = 0.002); food allergy (OR = 4.31; p = 0.026); mold exposure (OR = 3.81 p<0.01) and parental history of AR (OR = 1.42; p = 0.046). Due to the strong link between food allergy and peanut sensitization three models of multivariate logistic regression were performed and confirmed that AR is associated with peanut sensitization but also food allergy and mold exposure. A random forest analysis was also performed to explain AR. The results reinforced the logistic analysis that peanut sensitization and mold exposure were the principal determinants of AR.Conclusions & Clinical RelevanceThese results stress the importance of investigating AR in young children with asthma to potentially diagnose a particularly severe allergic asthmatic phenotype. Moreover, these data evoke the hypothesis that peanut could be an aeroallergen.
Highlights
Allergic rhinitis (AR) is an atopic manifestation frequently associated with asthma
Infants were allocated into two groups – one comprising children diagnosed with allergic rhinitis (AR) and the other comprising those without – in a randomized manner and adjusted for age and gender
The main result of our study is that independent variables for AR in young asthmatic children are mainly peanut sensitization and a moldy environment
Summary
Allergic rhinitis (AR) is an atopic manifestation frequently associated with asthma. The AR and its Impact on Asthma (ARIA)[4] classification further helps assess the severity of this pathology, as it takes into account the chronology of the symptoms and the discomfort they cause. The occurrence of AR in pre-school children is widely accepted [10,11,12], but diagnosis has long been overlooked or questioned in early infancy. This is mainly explained by its similarity with infectious symptoms which are frequent in toddlers. Recent works have highlighted the occurrence of AR in toddlers the causes of AR in this young population remain unknown. The objective of this study was to identify determinants of AR in young children with asthma
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