Top

Published in:

01-04-2013 | RHINITIS (JN BARANIUK AND JJ OPPENHEIMER, SECTION EDITORS)

Comparative Analysis of Allergic Rhinitis in Children and Adults

Authors: Adriana Izquierdo-Domínguez, Antonio L. Valero, Joaquim Mullol

Published in: Current Allergy and Asthma Reports | Issue 2/2013

Abstract

Allergic rhinitis (AR) is a worldwide health problem that generates a significant healthcare burden in adults, adolescents, and children. Epidemiological studies have indicated that the prevalence of AR has progressively increased over the last three decades in developed and industrialized countries. AR currently affects up to 40 % of the worldwide population, with differences between adults and children and different countries of the World. Although not life-threatening, AR symptoms are frequently bothersome, adversely affecting work and quality of life of the affected patients, and causing a significant burden on both the individual and society. The symptoms have the potential to lead to both physical and mental complications, with sleep-disordered breathing in childhood and adolescence being associated with disorders in learning performance, behavior, and attention. Clinical features and comorbidities are very important for the “allergic march”, and in both adults and children there is some evidence of association between AR and asthma. ARIA classifications of both symptom duration (intermittent, persistent) and severity (mild, moderate, severe) have been validated in both adult and pediatric populations. Based on the duration and severity of patient’s disease, an appropriate treatment strategy has been issued for both adults and children, which consists of patient’s education, allergen avoidance, and pharmacological as well as allergen-specific immunotherapy treatment. The present review will attempt to compare the characteristics of AR between children and adults, either in the epidemiology, clinical features, impact on QOL, and management of the disease.

Canonica GW, Bousquet J, Mullol J, Scadding GK, Virchow JC. A survey of the burden of allergic rhinitis in Europe. Allergy. 2007;62 Suppl 5:17–25.PubMedCrossRef

Nathan RA. The burden of allergic rhinitis. Allergy Asthma Proc. 2007;28:3–9.PubMedCrossRef

Morais-Almeida M, Gaspar A, Pires G, Prates S, Rosado Pinto J. Risk factors for asthma symptoms at school age: an 8-year prospective study. Allergy Asthma Proc. 2007;28:183–9.PubMedCrossRef

Annesi-Maesano I, Hulin M, Lavaud F, et al. Poor air quality in classrooms related to asthma and rhinitis in primary schoolchildren of the French 6 cities study. Thorax. 2012;67:682–8.PubMedCrossRef

Bousquet J, Khaltaev N, Cruz AA, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008. Allergy. 2008;63 Suppl 86:8–160.PubMedCrossRef

Valero A, Ferrer M, Sastre J, et al. A new criterion by which to discriminate between patients with moderate allergic rhinitis and patients with severe allergic rhinitis based on the allergic rhinitis and its impact on asthma severity items. J Allergy Clin Immunol. 2007;120:359–65.PubMedCrossRef

Valero A, Ferrer M, Baró E, et al. Discrimination between moderate and severe disease may be used in patients witheither treated or untreated allergic rhinitis. Allergy. 2010;65(12):1609–13.PubMedCrossRef

• Jáuregui I, Dávila I, Sastre J, et al. Validation of ARIA (Allergic Rhinitis and its Impact on Asthma) classification in a pediatric population: the PEDRIAL study. Pediatr Allergy Immunol. 2011;22:388–92. This article shows the validation of ARIA classification in children with allergic rhinitis.PubMedCrossRef

• Montoro J, Del Cuvillo A, Mullol J, et al. Validation of the modified allergic rhinitis and its impact on asthma (ARIA) severity classification in allergic rhinitis children: the PEDRIAL study. Allergy. 2012;67(11):1437–42. This article shows the validation of the modified ARIA severity classification in children with allergic rhinitis which discriminates moderate from severe disease among untreated patients.PubMedCrossRef

10.

Bousquet J, Bodez T, Gehano P, et al. Implementation of guidelines for allergic rhinitis in specialist practices. A randomized pragmatic controlled trial. Int Arch Allergy Immunol. 2009;150(1):75–82.PubMedCrossRef

11.

Bachert C, van Cauwenberge P, Olbrecht J, van Schoor J. Prevalence, classification and perception of allergic and non allergic rhinitis in Belgium. Allergy. 2006;61:693–8.PubMedCrossRef

12.

Bauchau V, Durham SR. Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J. 2004;24:758–64.PubMedCrossRef

13.

Nathan RA, Meltzer EO, Derebery J, et al. The prevalence of nasal symptoms attributed to allergies in the United States: findings from the burden of rhinitis in an America survey. Allergy Asthma Proc. 2008;29:600–8.PubMedCrossRef

14.

Jessen M, Malm L. Definition, prevalence and development of nasal obstruction. Allergy. 1997;52 Suppl 40:3–6.PubMedCrossRef

15.

• Katelaris CH, Lee BW, Potter PC, et al. Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America. Clin Exp Allergy. 2012;42:186–207. This manuscript presents the latest prevalences of allergic rhinitis in developed countries and in both children and adults.PubMedCrossRef

16.

Asher MI, Keil U, Anderson HR, et al. International study of asthma and allergies in childhood (ISAAC): rationale and methods. Eur Respir J. 1995;8:483–91.PubMedCrossRef

17.

Weiland SK, Björksten B, Brunekreef B, et al. Phase II of the International Study of Asthma and Allergies in Childhood (ISAAC II): rationale and methods. Eur Respir J. 2004;24:406–12.PubMedCrossRef

18.

Ellwood P, Asher MI, Beasley R, Clayton TO, Stewart AW, the ISAAC Steering Committee. The International Study of Asthma and Allergies in childhood (ISAAC): phase three rationale and methods. Int J Tuberc Lung Dis. 2005;9:10–6.PubMed

19.

Ait-khaled N, Odhiambo J, Pearce N, et al. Prevalence of symptoms of asthma, rhinitis and eczema in 13- to 14- year- old children in Africa: the International Study of Asthma and Allergies in Childhood Phase III. Allergy. 2007;62:247–58.PubMedCrossRef

20.

Strachan D, Sibbald B, Weiland S, et al. Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children: The International Study of Asthma and Allergies in Childhood (ISAAC). Paediatr Allergy Immunol. 1997;8:161–76.CrossRef

21.

Williams H, Robertson C, Stewart A, et al. Worldwide variations in the prevalence of symptoms of atopic eczema in the International Study of Asthma and Allergies in Childhood. J Allergy Clin Immunol. 1999;103:125–38.PubMedCrossRef

22.

Asher MI, Montefort S, Bjorksten B, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet. 2006;368:733–43.PubMedCrossRef

23.

Björksten B, Clayton T, Ellwood P, Stewart A, Strachan D, the ISAAC Phase Three Study Group. Worldwide time trends for symptoms of rhinitis and conjunctivitis: Phase III of the International Study of Asthma and Allergies in Childhood. Pediatr Allergy Immunol. 2008;19:110–24.PubMedCrossRef

24.

Ait-Khaled A, Pearce N, Anderson HR, Ellwood P, Montefort S, Shah J, ISAAC Phase Three Study Group. Global map of the prevalence of symptoms of rhinoconjunctivitis in children: the International Study of Asthma and Allergies in Childhood (ISAAC) phase three. Allergy. 2009;64(1):123–48.PubMedCrossRef

25.

Lødrup Carlsen KC, Söderström L, Mowinckel P, et al. Asthma prediction in school children; the value of combined IgE antibodies and obstructive airways disease severity score. Allergy. 2010;65:1134–40.PubMed

26.

Hopper JL, Jenkins MA, Carlin JB, Giles GG. Increase in the self-reported prevalence of asthma and hay fever in adults over the last generation: a matched parent-offspring study. Aust J Public Health. 1995;19:120–4.PubMedCrossRef

27.

Bauchau V, Durham SR. Epidemiological characterization of the intermittent and persistent types of allergic rhinitis. Allergy. 2005;60:350–3.PubMedCrossRef

28.

Cingi C, Topuz B, Songu M, et al. Prevalence of allergic rhinitis among the adult population in Turkey. Acta Otolaryngol. 2010;130:600–6.PubMedCrossRef

29.

Zhang L, Han D, Huang D, et al. Prevalence of self-reported allergic rhinitis in eleven major cities in China. Int Arch Allergy Immunol. 2009;149:47–57.PubMedCrossRef

30.

Neffen H, Mello JF, Sole D, et al. Nasal allergies in the Latin American population: results from the Allergies in Latin America survey. Allergy Asthma Proc. 2010;31 Suppl 1:S9–S23.PubMedCrossRef

31.

Settipane RA, Charnock DR. Epidemiology of rhinitis: allergic and nonallergic. Clin Allergy Immunol. 2007;19:23–34.PubMed

32.

Del Cuvillo A, Montoro J, Bartra J, et al. Validation of ARIA duration and severity classifications in Spanish allergic rhinitis patients−the ADRIAL cohort study. Rhinology. 2010;48(2):201–5.PubMed

33.

Guilemany JM, Garcia-Piñeiro A, Alobid I, et al. Persistent allergic rhinitis has a moderate impact on the sense of smell, depending on both nasal congestion and inflammation. Laryngoscope. 2009;119(2):233–8.PubMedCrossRef

34.

Hadley JA, Schaefer SD. Clinical evaluation of rhinosinusitis: history and physical examination. Otolaryngol Head Neck Surg. 1997;117:S8–S11.PubMedCrossRef

35.

Irwin RS. Silencing chronic cough [see comments]. Hosp Pract. 1999;34:53–60. quiz 129–30.5.CrossRef

36.

Kulig M, Klettke U, Wahn V, Forster J, Bauer CP, Wahn U. Development of seasonal allergic rhinitis during the first 7 years of life. J Allergy Clin Immunol. 2000;106:832–9.PubMedCrossRef

37.

Selnes A, Nystad W, Bolle R, Lund E. Diverging prevalence trends of atopic disorders in Norwegian children. Results from three cross sectional studies. Allergy. 2005;60:894–9.PubMedCrossRef

38.

Berger WE. Allergic rhinitis in children: diagnosis and management strategies. Paediatr Drugs. 2004;6:233–50.PubMedCrossRef

39.

Steele RW. Rhinosinusitis in children. Curr Allergy Asthma Rep. 2006;6:508–12.PubMedCrossRef

40.

Noone PG, Leigh MW, Sannuti A, et al. Primary ciliar dyskinesia: diagnostic and phenotypic features. Am J Respir Crit Care Med. 2004;169:459–67.PubMedCrossRef

41.

Zureik M, Neukirch C, Leynaert B, Liard R, Bousquet J, Neukirch F. Sensitisation to airborne moulds and severity of asthma: cross sectional study from European community respiratory health survey. BMJ. 2002;325:411–4.PubMedCrossRef

42.

Rosenstreich DL, Eggleston P, Kattan M, et al. The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma [see comments]. N Engl J Med. 1997;336:1356–63.PubMedCrossRef

43.

Lewis SA, Weiss ST, Platts-Mills TA, Burge H, Gold DR. The role of indoor allergen sensitization and exposure in causing morbidity in women with asthma. Am J Respir Crit Care Med. 2002;165:961–6.PubMed

44.

Chen WY, Tseng HI, Wu MT, et al. Synergistic effect of multiple indoor allergen sources on atopic symptoms in primary school children. Environ Res. 2003;93:1–8.PubMedCrossRef

45.

Shaaban R, Zureik M, Soussan D, et al. Allergic rhinitis and onset of bronchial hyperresponsiveness: a population-based study. Am J Respir Crit Care Med. 2007;176:659–66.PubMedCrossRef

46.

Rochat MK, Illi S, Ege MJ, et al. Allergic rhinitis as a predictor for wheezing onset in school-aged children. J Allergy Clin Immunol. 2010;126:1170–5–e2.CrossRef

47.

Shaaban R, Zureik M, Soussan D, et al. Rhinitis and onset of asthma: a longitudinal population-based study. Lancet. 2008;372:1049–57.PubMedCrossRef

48.

Camelo-Nunes I, Sole D. Allergic rhinitis: indicators of quality of life. J Bras Pneumol. 2010;36(1):124–33.PubMedCrossRef

49.

Gentile D, Shapiro G, Sloner D. Allergic rhinitis. In: Leung D, Sampson H, Geha R, Szefler S, editors. Pediatric allergy. Principles and practice. St. Louis: Mosby; 2003. p. 287–97.

50.

Hallstrand TS, Curtis JR, Aitken ML, Sullivan SD. Quality of life in adolescents with mild asthma. Pediatr Pulmonol. 2003;36:536–43.PubMedCrossRef

51.

Roberts G, Mylonopoulou M, Hurley C, Lack G. Impairment in quality of life is directly related to the level of allergen exposure and allergic airway inflammation. Clin Exp Allergy. 2005;35:1295–300.PubMedCrossRef

52.

Walker S, Khan-Wasti S, Fletcher M, Cullinan P, Harris J, Sheikh A. Seasonal allergic rhinitis is associated with a detrimental effect on examination performance in United Kingdom teenagers: case–control study. J Allergy Clin Immunol. 2007;120:381–7.PubMedCrossRef

53.

Meltzer EO, Blaiss MS, Derebery MJ, et al. Burden of allergic rhinitis: results from the Pediatric Allergies in America survey. J Allergy Clin Immunol. 2009;124:S43–70.PubMedCrossRef

54.

Juniper EF, Guyatt GH, Dolovich J. Assessment of quality of life in adolescents with allergic rhinoconjunctivitis: development and testing of a questionnaire for clinical trials. J Allergy Clin Immunol. 1994;93(2):413–23.PubMedCrossRef

55.

Juniper EF, Howland WC, Roberts NB. Measuring quality of life in children with rhinoconjunctivitis. J Allergy Clin Immunol. 1998;101:163–70.PubMedCrossRef

56.

Juniper EF, Guyatt GH. Development and testing of a new measure of health status for clinical trials in rhinoconjunctivitis. Clin Exp Allergy. 1991;21:77–83.PubMedCrossRef

57.

Juniper EF, Thompson AK, Ferrie PJ, Roberts JN. Development and validation of the mini rhinoconjunctivitis quality of life questionnaire. Clin Exp Allergy. 2000;30(1):132–40.PubMedCrossRef

58.

Juniper E, Rohrbaugh T, Meltzer EO. A questionnaire to measure quality of life in and adults with nocturnal allergic rhinoconjunctivitis. J Allergy Clin Immunol. 2003;111:484–90.PubMedCrossRef

59.

Valero A, Alonso J, Antepara I, et al. Development and validation of a new Spanish instrument to measure health-related quality of life in patients with allergic rhinitis: the ESPRINT questionnaire. Val Health. 2007;10(6):466–77.CrossRef

60.

Valero A, Alonso J, Antépara I, et al. Health-related quality of life in allergic rhinitis: comparing the short form ESPRINT-15 and MiniRQLQ questionnaires. Allergy. 2007;62(12):1372–8.PubMedCrossRef

61.

Valero A, Baró E, Sastre J, et al. Reference values for facilitating the interpretation of the ESPRINT-15 questionnaire (Spanish version). J Investig Allergol Clin Immunol. 2009;19(5):396–403.PubMed

62.

Valero A, Izquierdo I, Giralt J, et al. Rupatadine improves nasal symptoms, quality of life (ESPRINT-15) and severity in a subanalysis of a cohort of Spanish allergic rhinitis patients. J Investig Allergol Clin Immunol. 2011;21(3):229–35.PubMed

63.

Valero A, Muñoz-Cano R, Sastre J, et al. The impact of allergic rhinitis on symptoms, and quality of life using the new criterion of ARIA severity classification. Rhinology. 2012;50(1):33–6.PubMed

64.

Sardana N, Craig T. Congestion and sleep impairment in allergic rhinitis. Asian Pac J Allergy Immunol. 2011;29:297–306.PubMed

65.

Derebery J, Meltzer E, Nathan RA, et al. Rhinitis symptoms and comorbidities in the United States: Burden of rhinitis in America survey. Otolaryngol Head Neck Surg. 2008;139:198–205.PubMedCrossRef

66.

Mullol J. A survey of the burden allergic rhinitis in Spain. J Investig Allergol Clin Immunol. 2009;19(1):27–34.PubMed

67.

Marinho S, Simpson A, Custovic A. Allergen avoidance in the secondary and tertiary prevention of allergic diseases: does it work? Prim Care Respir J. 2006;15:152–8.PubMedCrossRef

68.

Filon FL, Radman G. Latex allergy: a follow up study of 1040 healthcare workers. Occup Environ Med. 2006;63:121–5.PubMedCrossRef

69.

Fink RS, Pierre LN, Daley Yates PT, Richards DH, Gibson A, Honour JW. Hypothalamic-pituitaryadrenal axis function after inhaled corticosteroids: unreliability of urinary free cortisol estimation. J Clin Endocrinol Metab. 2002;87:4541–6.PubMedCrossRef

70.

Sastre J, Mosges R. Local and systemic safety of intranasal corticosteroids. J Investig Allergol Clin Immunol. 2012;22(1):1–12.PubMed

71.

•• Brozek JL, Bousquet J, Baena-Cagnani CE, Global Allergy and Asthma European Network, Grading of Recommendations Assessment, Development and Evaluation Working Group, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010;126(3):466–76. This manuscript shows the GRADE-based ARIA recommendations on the prevention and treatment of adults and children with allergic rhinitis, with and without comorbid asthma.PubMedCrossRef

72.

Schünemann HS, Jaeschke R, Cook DJ, et al. An official ATS statement: grading the quality of evidence and strength of recommendations in ATS guidelines and recommendations. Am J Respir Crit Care Med. 2006;174:605–14.PubMedCrossRef

73.

Brozek JL, Baena-Cagnani CE, Bonini S, et al. Methodology for development of the Allergic Rhinitis and its Impact on Asthma guideline 2008 update. Allergy. 2008;63:38–46.PubMedCrossRef

74.

Calderon M, Gerth van Wijk R, Eichler I, et al. Perspectives on allergen-specific immunotherapy in childhood: An EAACI position statement. Pediatr Allergy Immunol. 2012;23:300–6.PubMedCrossRef

75.

European Declaration on Immunotherapy: Combating Allergy Beyond Symptoms.http://eaaci.net/eaacimedia/1663-eaacipresents-theeuropean-declaration-onallergen-immunotherapy.

76.

Calderon M, Cardona V, Demoly P, on behalf of the EAACI 100 Years of Immunotherapy Experts Panel. One hundred years of allergen immunotherapy European Academy of Allergy and Clinical Immunology celebration: review of unanswered questions. Allergy. 2012;67:462–76.PubMedCrossRef

Title: Comparative Analysis of Allergic Rhinitis in Children and Adults
Authors: Adriana Izquierdo-Domínguez
Antonio L. Valero
Joaquim Mullol
Publication date: 01-04-2013
Publisher: Current Science Inc.
Published in: Current Allergy and Asthma Reports / Issue 2/2013
Print ISSN: 1529-7322
Electronic ISSN: 1534-6315
DOI: https://doi.org/10.1007/s11882-012-0331-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparative Analysis of Allergic Rhinitis in Children and Adults

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2013

Rhinitis in Older Adults

Role of Leukotriene Antagonists and Antihistamines in the Treatment of Allergic Rhinitis

Nasal Saline Irrigations for the Symptoms of Acute and Chronic Rhinosinusitis

Oral Steroid Therapy in Chronic Rhinosinusitis with and without Nasal Polyposis

Impact of Sleep as a Specific Marker of Quality of Life in Allergic Rhinitis

Balloon Dilation Technology: Let the Truth Be Told