Local allergic rhinitis: a pediatric perspective

Rhinitis is an inflammation of the nasal mucosa.To manifest as chronic, two or more nasal symptoms, such as congestion, rhinorrhea, sneezing, and itching should persist for at least an hour a day for more than two weeks. 1 There are mainly two subgroups of chronic rhinitis: allergic rhinitis (AR), and non-allergic rhinitis (NAR). 2 Non-allergic rhinitis is a heterogenous group including occupational rhinitis, gustatory rhinitis, atrophic rhinitis, rhinitis of elderly, drug-induced rhinitis, hormonal rhinitis, coldair induced rhinitis and idiopathic rhinitis. 2Allergic rhinitis is a relatively homogeneus entity with nasal eosinophilia due to IgEmediated inflammation. 3Patients with allergic rhinitis have positivity for at least one of markers of atopy such as skin prick test (SPT) and/or serum allergen specific IgE (sIgE) 3 , whereas NAR patients test negative for both. 4However, this classification is very simplistic, and mixed phenotypes may exist in a subgroup of patients.Some authors argue that a new classification depending on the endotypes is needed. 5Studies from 1999 to 2004 by the International Study of Asthma and Allergies in Childhood (ISAAC) revealed prevalences of rhinitis at 8.5% in children aged 6-7 and 14.6% aged 13-14. 6The 1989 Isle of Wight birth cohort of 1456 children reported prevalences of 2.8% and 11.8% in children aged 4 and 18, respectively, for rhinitis in individuals that have no allergic sensitization.The prevalences were reported as 3.4 % and 27.3%, respectively, for the same age groups with allergic sensitization. 7Males are more susceptible to AR, and females