Local allergic rhinitis in children: A systematic review

Abstract

Background: Local allergic rhinitis (LAR) is a well-defined and reported phenotype in adults, but data is scarce for children and adolescents, and it is probably an undiagnosed and highly underestimated condition in childhood. Objectives: The objectives of this systematic review were to identify original observational studies published on LAR in children and adolescents and to describe the prevalence and characteristics of this phenotype in the pediatric age group. Methods: A systematic search was performed in PubMed and EMBASE databases. The search was limited to publications on humans, written in English, published between January 1, 2000 and September 20, 2021. Participants had to be under 18 years old and with a diagnosis of LAR confirmed by nasal allergen provocation test (NAPT). Results: Ten articles were identified. Despite the wide variability of protocols, prevalence rates ranged from 3.7 to 83.3% among children previously diagnosed as having nonallergic rhinitis, being markedly lower in Eastern countries (3.7–16.6%) when compared to Western countries (22.3–83.3%). To date, no relevant clinical characteristics capable of differentiating LAR patients from other childhood rhinitis phenotypes have been identified. Conclusions: LAR is an allergic rhinitis phenotype also found in children. Population and regional differences and differences in NAPT protocols may explain the heterogeneity in LAR prevalence rates observed in different parts of the world. In addition to clarifying this large discrepancy, longitudinal studies are also needed to assess the clinical characteristics of the LAR phenotype in the pediatric age group, and its stability into adulthood must be confirmed.

The aspects of local allergic rhinitis in Polish children and adolescents

“…Compared to NAR, individuals with LAR reported more family history of atopy (62.8% vs. 16%) and more common exposure to house dust (60.5% vs. 12.9%). This was broadly consistent with our observations, with NAR patients testing negative and sIgE to all allergens, including house dust mites [5].…”

“…The occurrence of LAR in children and adolescents is relatively little studied. Several observational studies and meta-analyses emphasise the significant occurrence of this endotype of rhinitis in the youngest patients [ 5 , 6 ]. In one study, authors found a 24.9 % incidence of LAR in patients with non-atopic rhinitis < 18 years of age.…”

“…Despite many studies analysing the prevalence, phenotype and mechanism of LAR, there are still many pending questions, for example, about the importance of this disease in children. Significant variation in the rate of LAR diagnoses (3.7–83.3%) in children and adolescents previously classified as having NAR [ 5 ] was observed. LAR is underdiagnosed and probably undertreated in those groups of patients.…”

Дослідження Клініко-Лабораторних Особливостей Дітей Молодшого Шкільного Віку З Підозрою На Локальний Алергічний Риніт

“…Цим обумовлюється і неоднорідність даних про поширеність ЛАР серед дітей, що складає від 3,7% до 83,3% залежно від країни. Більшість фахівців вважають ЛАР як недооцінений стан у дитинстві, що призводить да невчасної діагностики та неадекватного лікування цього фенотипу дитячого риніту [9].…”