[Quality of life in children with allergic rhinitis before and after being treated with specific immunotherapy (cases and controls)].
BACKGROUND
Rhinitis is the most frequent allergic disease in children. Symptoms may affect importantly life quality. Measures to avoid allergens when possible and the use of drugs are an important part of the treatment; however, specific immunotherapy is the only treatment altering the natural course of the disease.


OBJECTIVE
To assess if specific immunotherapy improves life quality in children with allergic rhinitis.


METHODS
Patients who attended to the allergy department during August and September 2002, and who fulfilled the inclusion criteria, were included. Two groups of treatment were formed: group A received specific immunotherapy with standardized allergenic extracts, from IPI ASAC Mexico. They started with a concentration of 0.07 bioequivalent units (BEU), with twice-a-week-application with increases of 10 (0.7, 7 and 80 BEU) each seven weeks up to maintenance dose of 700 BEU at six months. Group B only was given pharmacological treatment. Paediatric Rhinoconjunctivitis Quality of Life Questionnaires, specific to children with allergic rhinoconjunctivitis, validated for its use in Spanish in Mexican children by the department of Clinical Epidemiology and Biostatistics of Mc Master University, were applied to all patients.


RESULTS
Twenty-seven patients were included in each group, 14 males, adjusted for age with a correlation coefficient (r2) = 0.9799. In both groups, mean age was of 11 years 6 months (group A: 7 to 16 years, group B: 7 to 17 years). Eighteen (44.4%) and fifteen patients (33.3%), of groups A and B respectively, had persistent mild rhinitis, and 9 (55.6%) and 12 cases (66.7%) of groups A and B, respectively, had moderate persistent rhinitis. All of them were sensitized to domiciliary allergens. As to life quality a high odds ratio (OR) was found when assessing patients six months after treatment, especially in nasal symptoms such as pruritus (OR = 6.8) and obstruction (OR = 5.9). Also for practical symptoms the OR was high: carving eyes and nose (OR = 7), blowing the nose (OR = 4.8) and carrying disposable tissues (OR = 4.7). OR for other symptoms was as follows: thirst and throatitch, OR = 4; irritability, OR = 6.2, and ocular pruritus, OR = 3.1. Patients without immunotherapy were likely to use more drugs (OR = 6.4) than those receiving immunotherapy.


CONCLUSIONS
We did not find controlled studies on life quality with the use of immunotherapy in children. In this study, specific immunotherapy was found to improve life quality in children with allergic rhinoconjunctivitis, especially in nasal symptoms, such as pruritus and obstruction, as well as in practical symptoms. These results are similar to those by Fell, who found that 92% patients referred an improvement of nasal symptoms, a better labor performance and a lesser use of drugs after four months of using immunotherapy.
Moncayo Coello
Carol Vivian
CV
Departamento de Alergia e Inmunología Clínica, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, CP 06720, México. vivianmoncayo@hotmail.com
Rosas Vargas
Miguel Angel
MA
del Rio Navarro
Blanca Estela
BE
Lerma Ortiz
Lourdes
L
Velázquez Armenta
Yadira
Y
Sienra Monge
Juan José
JJ
D000293:Adolescent; D000485:Allergens / Q000627:therapeutic use; D000818:Animals; D002415:Cats; D002648:Child; D003058:Cockroaches; D003233:Conjunctivitis, Allergic / Q000523:psychology / Q000628:therapy; D003888:Desensitization, Immunologic; D005260:Female; D006801:Humans; D008297:Male; D008925:Mites; D011788:Quality of Life; D012221:Rhinitis, Allergic, Perennial / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
D000485:Allergens