Introduction

Rhinitis is a prevalent disorder in children. Mucosal congestion, nasal discharge, mouth breathing and initial fever manifest it in the acute stage. In the chronic situation, the child may suffer from snoring, chronic fatigue and hearing loss.

Allergic rhinitis may or may not be due to atopy. Two factors are required for the development of IgE-mediated allergic rhinitis - the inheritable atopic state and the development of sensitivity to allergens present in the patient's environment. Allergic rhinitis may be intermittent (seasonal) or persistent (perennial). Intermittent rhinitis e.g. hay fever may occur in the spring and summertime in response to exposure to wind-borne pollens, whereas the symptoms of persistent rhinitis are present throughout the year. It is not clear whether non-IgE mediated forms of allergic rhinitis can be defined further.

 

Non-allergic rhinitis: All other forms of rhinitis should be included under this term, including such phenomena as aspirin hypersensitivity, infectious reactions, non-specific nasal hyperresponsiveness, side-effects of systemic drugs, and abuse of topical decongestants. In general, the younger the patient, the more likely it is that the symptoms are due to allergic rhinitis. Non-allergic rhinitis is more likely to occur in adolescence or adulthood.

Prevalence

Rhinitis and conjunctivitis in childhood is reported to affect 10-15% and is a common reason for school absenteeism. Allergen-specific IgE antibodies are found in 60-80% of theese children. The majority of these children also have some other symptoms of allergy, such as wheezing, nocturnal coughing or eczema.