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.


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.

Analysis of a database to predict the result of allergy testing American Journal of Rhinology & Allergy, Volume 28, Number 5, September/October 2014, pp. 414-418(5) http://bit.ly/1udyzC8

Nonallergic rhinitis, CCJM 2012 review.

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