Rinitis alérgica en pediatría: recomendaciones para su diagnóstico y tratamiento / Allergic rhinitis in pediatrics: recommendations for diagnosis and treatment

La rinitis alérgica (RA) es una de las enfermedades crónicas más frecuentes de la infancia. Sin embargo, permanece subdiagnosticada y subtratada. Su prevalencia ha aumentado en los últimos años y varía del 2 % al 25 %. Los síntomas de la RA incluyen estornudos, prurito, rinorrea y congestión nasal. Un correcto diagnóstico y tratamiento de la RA y sus comorbilidades, tales como rinosinusitis con o sin poliposis nasal, conjuntivitis, otitis media, asma bronquial e infecciones del tracto respiratorio, son importantes para reducir el impacto negativo en la afectación de la calidad de vida del paciente y sus familiares, y los gastos sanitarios que ocasiona. La inmunoterapia alérgeno específica, en pacientes correctamente seleccionados, previene nuevas sensibilizaciones y reduce la hiperreactividad bronquial asociada a la RA. Considerando todos estos factores, el Comité Nacional de Alergia de la Sociedad Argentina de Pediatría propone recomendaciones basadas en la evidencia actual.

Allergic rhinitis (AR) is one of the most common chronic diseases in children. However, it remains underdiagnosed and undertreated. Its prevalence has increased in recent years and varies from 2 to 25 %. Symptoms include sneezing, itching, runny nose, and nasal congestion. A correct diagnosis and treatment of AR and its comorbidities such as rhinosinusitis with or without nasal polyposis, conjunctivitis, otitis media, bronchial asthma and respiratory tract infections, are important to reduce the negative impact on the quality of life of the patient and their relatives, and in medical costs. Specific allergen immunotherapy, in correctly selected patients, prevents new sensitizations and reduces bronchial hyperreactivity associated with AR. Taking into account all these reasons, the National Allergy Committee of the Sociedad Argentina de Pediatría proposes current evidence based recommendations

[Allergic rhinitis in pediatrics: recommendations for diagnosis and treatment]. / Rinitis alérgica en pediatría: recomendaciones para su diagnóstico y tratamiento.

Allergic rhinitis (AR) is one of the most common chronic diseases in children. However, it remains underdiagnosed and undertreated. Its prevalence has increased in recent years and varies from 2 to 25 %. Symptoms include sneezing, itching, runny nose, and nasal congestion. A correct diagnosis and treatment of AR and its comorbidities such as rhinosinusitis with or without nasal polyposis, conjunctivitis, otitis media, bronchial asthma and respiratory tract infections, are important to reduce the negative impact on the quality of life of the patient and their relatives, and in medical costs. Specific allergen immunotherapy, in correctly selected patients, prevents new sensitizations and reduces bronchial hyperreactivity associated with AR. Taking into account all these reasons, the National Allergy Committee of the Sociedad Argentina de Pediatría proposes current evidence based recommendations.

La rinitis alérgica (RA) es una de las enfermedades crónicas más frecuentes de la infancia. Sin embargo, permanece subdiagnosticada y subtratada. Su prevalencia ha aumentado en los últimos años y varía del 2 % al 25 %. Los síntomas de la RA incluyen estornudos, prurito, rinorrea y congestión nasal. Un correcto diagnóstico y tratamiento de la RA y sus comorbilidades, tales como rinosinusitis con o sin poliposis nasal, conjuntivitis, otitis media, asma bronquial e infecciones del tracto respiratorio, son importantes para reducir el impacto negativo en la afectación de la calidad de vida del paciente y sus familiares, y los gastos sanitarios que ocasiona. La inmunoterapia alérgeno específica, en pacientes correctamente seleccionados, previene nuevas sensibilizaciones y reduce la hiperreactividad bronquial asociada a la RA. Considerando todos estos factores, el Comité Nacional de Alergia de la Sociedad Argentina de Pediatría propone recomendaciones basadas en la evidencia actual.

[Analysis of nasal cytology in children and adolescents with rhinitis]. / Análisis de la citología nasal en niños y adolescentes con rinitis.

BACKGROUND: Nasal cytology in a easy-to apply method to differentiate rhinitis phenotypes from a physiopathogenic and diagnostic perspective. There are controversies about the relationship between clinical severity of rhinitis and inflammatory patterns expressed in the nasal cytology. OBJECTIVES: To study the characteristic of the eosinophil and neutrophil patterns in the nasal scraping for Allergic Rhinitis (AR) and Non Allergic Rhinitis (NAR) and its relationship with the clinical grades of rhinitis established by the Allergic Rhinitis and its Impact on Asthama Guideline (ARIA) Methods: In a observational, cross-sectional study we included patients aged 5 to 18 years presenting symptoms of either allergic (AR) or non- allergic rinitis (NAR) without asthma. Cytology was performed by analyzing nasal scraping obtained from the mucosal surface of the inferior turbinate and samples were stained using thr hematoxylin and eosin stain procedure. Inflammatory patterns between AR and NAR and between clinical grades of rhinitis classified by ARIA guide were compared. RESULTS: A total of 231 patients were included. Patients with AR exhibited higher percentage of eosinophils in nasal cytology than those with NAR (p = 0.0012) but no differences were observed in neutrophil count (p = 0.4011). No differences in the percentage of eosinophils and neutrophils between different grades of AR (p = 0.7342 and p = 0.0797 respectively) and NAR (p = 0.1010 and p = 0.1422 respectively) were observed. CONCLUSION: Eosinophil count in the nasal cytology was useful to differentiate rhinitis with a positive allergen skin test from rhinitis with negative skin test, but as neutrophils count, does not help to distinguish clinical grades of AR and NAR as classified by ARIA.