Allergic Rhinitis.

Pediatr Rev

Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ.

Published: October 2023

AI Article Synopsis

  • Allergic rhinitis (AR) is a common chronic disease affecting over 400 million people globally, with rising cases particularly among children, often starting before age 6.
  • Many underserved and urban populations face underdiagnosis, leading to healthcare disparities and worsening outcomes, such as poor asthma control in untreated children.
  • Treatment options for AR have expanded to include various medications, allergen immunotherapy, and biological therapies, and children with severe or persistent symptoms should be referred to allergists for comprehensive care.

Article Abstract

Allergic rhinitis (AR) affects more than 400 million people worldwide, making it 1 of the most prevalent chronic diseases. Childhood AR is increasing, and almost half of patients with AR develop symptoms before age 6 years. Although a diagnosis of AR is associated with higher socioeconomic status, underserved and urban populations have more indoor aeroallergen sensitizations and are likely underdiagnosed with AR, further exacerbating health-care disparities. AR negatively impacts quality of life, school performance, and overall health outcomes. Untreated AR in children increases the risk for poor asthma control, increased asthma severity, and exacerbations. Many patients believe that they have seasonal allergies only but in reality have both perennial and seasonal AR, which may change the approach to allergen avoidance measures and treatment recommendations. Pharmacotherapy of AR has expanded, with many intranasal corticosteroids, intranasal antihistamines, and second-generation oral antihistamines approved for pediatric use. Allergen immunotherapy, including both subcutaneous and sublingual forms, are approved for children and are disease modifying, potentially reducing further allergen sensitization and progression to asthma. Many of the currently available biological therapies indicated for pediatric asthma and/or atopic diseases reduce AR symptoms as well. Children with moderate to severe or refractory AR or those with comorbidities should be referred to allergists for diagnostic testing and expanded management options, including immunotherapy and potential biological treatment.

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Source
http://dx.doi.org/10.1542/pir.2022-005618DOI Listing

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