Analysis of factors associated with the development of allergic rhinitis in children

  The incidence of allergic rhinitis in children increases gradually in school-age children, from 15% at age 6-7 years to as high as 40% by age 13-14 years. Allergen prick test (SPT) results show that more than two-thirds of children are positive for at least one perennial allergen, but all exhibit a distinct seasonal pattern of late summer and early fall onset. This is, on the one hand, related to the high concentration of weed pollen allergens such as artemisia and grasses in the northern region during that season, with a positive SPT rate of 62% for pollen in that season, and 36%, 31% and 22% for Artemisia, summer and autumn pollen and grasses, respectively, in this group of children; on the other hand, it is related to the increased concentration of perennial allergens, such as mites and molds, in a particular season. The age of the child usually influences the incidence of sensitization to certain allergens. In this study, the rate and trend of allergen SPT positivity in all age groups were the same as in the relevant literature. Mites, the most common indoor perennial allergens, had the highest positive rate in this study, with no statistically significant differences among age groups. While the positive rate of pollen in children increased with the age of the children, the survey found that the positive rate of Artemisia and summer and autumn pollen increased significantly with age, and the difference was statistically significant. Allergic rhinitis with conjunctivitis symptoms was diagnosed as allergic rhinoconjunctivitis with more certainty. The results of this study showed that the prevalence of allergic rhinitis combined with allergic conjunctivitis was 65%, which is a high prevalence and similar to the literature. Because the prognosis of children with untreated allergic conjunctivitis is poor, with only 20% of children having symptoms that disappear by adulthood, allergic conjunctivitis, as an important co-morbidity, should be covered in future guidelines for the treatment of asthma, allergic rhinitis, and allergic dermatitis. In addition, the higher the symptom score of allergic rhinitis and the higher the number of allergens, the higher the likelihood of co-morbid allergic conjunctivitis, a point that is an important hint for the diagnosis of conjunctivitis. A growing body of evidence has led to a consensus on the combined airways, with the upper and lower airways considered as the same immune mechanism. The positive rate of airway hyperreactivity in children with allergic rhinitis in this study was 77%, again supporting this view. porsbjerg et al. showed that the presence of airway hyperreactivity in childhood and concomitant allergic disease significantly increased the risk of developing asthma in adulthood and could be considered an important indicator of prognosis and further suggested that airway hyperreactivity could serve as a separate prognostic sign for asthma. The literature confirms that children with allergic rhinitis likewise increase the incidence of asthma shirts, with 58% to 85% of asthmatics having rhinitis followed by asthma or asthma and rhinitis occurring together. In our group of children with allergic rhinitis, all of whom had moderate to severe disease, the difference in the incidence of airway hyperreactivity compared with the control group was statistically significant, suggesting that it is more important to intensify intervention in this population with active treatment of allergic rhinitis and prophylactic treatment of asthma to slow and prevent the onset of asthma.