DIFFERENTIATION BETWEEN ALLERGIC AND NON-ALLERGIC RHINITIS IN CHILDREN WITH CHRONIC RHINITIS, ALLERGY CLINIC, PHRAMONGKUTKLAO HOSPITAL

Abstract

Background: Chronic rhinitis in children is a common problem. Investigation to diagnose allergic rhinitis (AR) using a skin prick test for aeroallergens requires a specialist doctor, which is not simply performed in primary health care facilities. Therefore, diagnosing patients with AR and non-allergic rhinitis (NAR) is based on clinical symptoms essential for treatment planning. This study compared clinical symptoms between AR and NAR, comorbidities, disease severity, and common aeroallergen sensitization.
 Methods: A retrospective descriptive study was conducted among participants aged between 2-18 years with chronic rhinitis who were treated at the Department of Allergy and Immunology, Division of Pediatrics, Phramongkutklao Hospital, between 2014 and 2018. The medical records were reviewed on clinical symptoms, allergic test results, environmental data, and the severity according to Allergic Rhinitis and its Impact on Asthma (ARIA) classification. If the patient tested positive for aeroallergen, the allergist diagnosed AR. NAR is characterized by the same symptoms but with a negative skin prick test.
 Results: Three hundred and seven participants were included. Among these patients, 226 (73.6 %) were categorized as AR, and 81 (26.4%) were NAR. The AR group had a higher percentage of males than the NAR group. Nasal pruritus and ocular symptoms were more commonly found in AR than in NAR. Regarding comorbidities, both groups had similar snoring, sinusitis, asthma, and atopic dermatitis. The most common aeroallergens among AR patients were Dermatophagoides pteronyssinus (82.7%), Dermatophagoides farinae (81.4%), followed by American cockroaches (38.1%), and German cockroaches (37.6%). Cat owners were associated with cat sensitization in AR patients (OR =2.77; 95% CI = 1.27-5.88).
 Conclusions: In this study, the proportion of AR was higher than NAR. Nasal pruritus, ocular symptoms, or both strongly supported AR. The most common aeroallergen sensitization was house dust mites, followed by cockroaches. Initial treatment with antihistamine and other drugs can improve the severity of the disease.