Rhinitis is a common problem in childhood and adolescence and impacts negatively on physical, social and psychological well-being. This position paper, prepared by the European Academy of
Allergy and Clinical Immunology Taskforce on
Rhinitis in Children, aims to provide evidence-based recommendations for the diagnosis and
therapy of paediatric
rhinitis.
Rhinitis is characterized by at least two nasal symptoms: rhinorrhoea, blockage,
sneezing or
itching. It is classified as
allergic rhinitis, infectious
rhinitis and nonallergic, noninfectious
rhinitis. Similar symptoms may occur with other conditions such as adenoidal
hypertrophy, septal deviation and
nasal polyps. Examination by anterior rhinoscopy and
allergy tests may help to substantiate a diagnosis of
allergic rhinitis. Avoidance of relevant
allergens may be helpful for
allergic rhinitis (AR). Oral and intranasal
antihistamines and nasal
corticosteroids are both appropriate for first-line AR treatment although the latter are more effective. Once-daily forms of
corticosteroids are preferred given their improved safety profile. Potentially useful add-on
therapies for AR include oral
leukotriene receptor antagonists, short bursts of a
nasal decongestant, saline douches and nasal
anticholinergics.
Allergen-specific
immunotherapy is helpful in
IgE-mediated AR and may prevent the progression of allergic disease. There are still a number of areas that need to be clarified in the management of
rhinitis in children and adolescents.