8% of 4-year-old children have non-allergic rhinitis vs. 5% who have allergic rhinitis

This study from Sweden provides data from a large birth cohort of 2,000 children about the natural course and comorbidities of rhinitis in children.

Information on IgEs against 8 common inhaled allergens was available, and was collected at age 4 and 8 years.

The children were assigned to one of 4 groups:

- allergic rhinitis (rhinitis with sensitization to allergens)
- nonallergic rhinitis (rhinitis without sensitization)
- allergic sensitization but no rhinitis
- neither rhinitis nor sensitization.

Allergic rhinitis (AR)

The proportion of children with allergic rhinitis increased from 5% to 14% from age 4 to 8 years. Of the children with allergic rhinitis when they were 4 years old, 12% underwent remission by the time they were 8 years old.

Among 4- and 8-year-olds, allergic rhinitis and nonallergic rhinitis were associated with asthma, eczema, and food hypersensitivity (allergic or atopic march).



Allergic (atopic) march (click here to enlarge the image).

25% of 8-year-olds with allergic rhinitis also had oral allergy syndrome (OAS).


Cross-reactivity in Pollen-Food Allergy Syndrome (PFAS) or Oral Allergy Syndrome (OAS) (click to enlarge the image).

Non-allergic rhinitis (NAR)

The proportion of children with nonallergic rhinitis decreased slightly over the same period of development, from 8% to 6%. Of the children with nonallergic rhinitis, 73% underwent remission during this period of development.

Among 4-year-olds without rhinitis who were sensitized to allergen, 56% had allergic rhinitis when they were 8 years old.

Sensitization to inhaled allergens at an early age (4 years) precedes the development of allergic rhinitis.

References:

Natural course and comorbidities of allergic and nonallergic rhinitis in children. Westman M, Stjärne P, Asarnoj A, Kull I, van Hage M, Wickman M, Toskala E. J Allergy Clin Immunol. 2011 Nov 5.

Nonallergic rhinitis, CCJM 2012 review.