Clinical characteristics of allergic rhinitis and nonallergic rhinitis in Korean children

Na Hae Won; Sang Hyun Park; So Hyun Ahn; Chae Bong Kim; Jung Hyun Kwon; Won Hee Seo; Dae Jin Song; Young Yoo

doi:10.4168/aard.2020.8.1.20

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Won, Park, Ahn, Kim, Kwon, Seo, Song, and Yoo: Clinical characteristics of allergic rhinitis and nonallergic rhinitis in Korean children

Original Article

Allergy, Asthma & Respiratory Disease 2020; 8(1): 20-29.

Published online: 31 January 2020

DOI: https://doi.org/10.4168/aard.2020.8.1.20

Clinical characteristics of allergic rhinitis and nonallergic rhinitis in Korean children

Na Hae Won¹, Sang Hyun Park¹, So Hyun Ahn², Chae Bong Kim³, Jung Hyun Kwon¹, Won Hee Seo¹, Dae Jin Song¹, Young Yoo^1,^2,³

¹Department of Pediatrics, Korea University Medical College, Seoul, Korea.

²Allergy Immunology Center, Korea University, Seoul, Korea.

³Environmental Health Center, Korea University Anam Hospital, Seoul, Korea.

Correspondence to: Young Yoo. Department of Pediatrics, Korea University Medical College, 73 Inchon-ro, Sungbuk-gu, Seoul 02841, Korea. Tel: +82-2-920-5090, Fax: +82-2-922-7476, yoolina@korea.ac.kr

Received 3 June 2019 Revised 11 September 2019 Accepted 11 September 2019

The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).

Abstract

Purpose

Recently, the prevalence of allergic rhinitis (AR) in Korean children has been increased. The aim of this study was to investigate the clinical characteristics of rhinitis and to compare clinical parameters between AR and nonallergic rhinitis (NAR) in children.

Methods

We retrospectively reviewed the medical records of 1,034 children under 18 years of age who visited Korea University Anam Hospital for rhinitis symptoms from January 2008 to December 2017. Clinical data, including clinical features, comorbidities, blood test results, allergen sensitization profile, and pulmonary function test parameters, were collected.

Results

Among the 1,034 children with rhinitis, 737 (71.3%) were AR and 297 (28.7%) were NAR. The prevalence of AR gradually increased with age. The median levels of eosinophil count (4.1%), serum total IgE (204.4 IU/L), eosinophil cationic protein (ECP) concentration (17.9 µg/L), and fractional exhaled nitric oxide (FeNO) (22.0 ppb) were significantly higher in children with AR than in those with NAR. The sensitization rate to the inhalant allergens increased with age; however, food allergen sensitization rate tended to decrease. Median levels of eosinophil count, total IgE, ECP, and FeNO were significantly higher in the poly-sensitized group than in the mono-sensitized and nonsensitized groups.

Conclusion

More than 70% of Korean children who have rhinitis symptoms are AR. Children with AR more likely to have higher levels of FeNO and bronchial asthma. Poly-sensitized children showed increased rates of atopic dermatitis and bronchial asthma.

Keywords: Allergic rhinitis, Nonallergic rhinitis, Child

Figures and Tables

Fig. 1

Prevalence of allergic rhinitis (AR) and nonallergic rhinitis (NAR) at different ages.

Fig. 2

Sensitization profiles in children with allergic rhinitis according to the age groups. HDM, house dust mite; CR, cockroach.

Table 1

Demographics of study subjects

Values are presented as median (interquartile range) or number (%).

AR, allergic rhinitis; AD, atopic dermatitis; WBC, white blood cell; ESR, erythrocyte sedimentation rate; IgE, immunoglobulin E; ECP, eosinophil cationic protein.

Table 2

Pulmonary function test results in subjects with AR and non-AR

Values are presented as median (interquartile range).

AR, allergic rhinitis; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; FEF_25%–75%, forced expiratory flow between 25% and 75% of vital capacity; FeNO, fractional exhaled nitric oxide.

Table 3

Medication use in subjects with AR and non-AR

Values are presented as number (%).

AR, allergic rhinitis; INS, intranasal steroid; LTRA, leukotriene receptor antagonist.

Table 4

Characteristics of study subjects according to the age groups

Values are presented as median (interquartile range) or number (%).

AR, allergic rhinitis; AD, atopic dermatitis.

^*Linear-by-linear association test.

Table 5

Characteristics of study subjects according to the sensitization profile (total=1,034)

Values are presented as median (interquartile range) or number (%).

AR, allergic rhinitis; AD, atopic dermatitis; WBC, white blood cell; ESR, erythrocyte sedimentation rate; IgE, immunoglobulin E; ECP, eosinophil cationic protein; FEV1, forced expiratory volume in one second; FVC, forced vital capacity; FEF_25%–75%, forced expiratory flow between 25% and 75% of vital capacity; FeNO, fractional exhaled nitric oxide.

^*Linear-by-linear association or Jonckheere-Terpstra test.

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ORCID iDs: Young Yoo
https://orcid.org/0000-0003-3354-6969
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