Clinical characteristics of children with non-allergic rhinitis vs with allergic rhinitis

Background: Allergic rhinitis (AR) and nonallergic rhinitis (NAR) are major causes of chronic rhinitis. Knowledge about children with non-allergic rhinitis is limited. Objective: To study clinical characteristics differentiating NAR and AR among children with chronic rhinitis. Methods: This is a retrospective, descriptive study of 302 children (with ages of 14 years or less) with chronic rhinitis evaluated at the pediatric allergy clinic, Siriraj Hospital between January and December 2006. Based on the results of skin prick test (SPT), they were classified into 2 groups, i.e., AR and NAR. Their medical records were reviewed with respect to clinical data on rhinitis and related symptoms. Results: There were 222 patients with AR and 80 with NAR (73.5% and 26.5%). Median age of onset of the disease among patients with NAR was younger than AR (p = 0.04) while the duration of disease among AR cases was longer than in NAR (p < 0.01). Severity of rhinitis, based on Allergic Rhinitis and its Impact on Asthma (ARIA), was not different between the two groups. Nasal pruritus, sneezing and eye symptoms were more commonly observed in AR than in NAR (p <0.01), whereas snoring and sinusitis were more common in NAR than in AR (p < 0.01). The presence of nasal pruritus, sneezing and eye symptoms strongly suggested AR (adjusted OR 2.73, 2.96, 1.49) while snoring was a risk factor for NAR (adjusted OR = 3.11). Conclusion: Presence of nasal pruritus, sneezing and eye symptoms suggests AR. Sinusitis and upper airway obstruction are more common among patients with NAR.