title: Epidemiological analysis of chronic rhinitis in pediatric patients.
abstract: BACKGROUND
  Nonallergic rhinitis is a poorly understood entity, especially among pediatric patients.
  
  
  OBJECTIVE
  The objective of this study was to identify clinical features that may distinguish phenotypes of allergic and nonallergic patients and to evaluate the usefulness of current diagnostic modalities.
  
  
  METHODS
  We reviewed medical records for 151 pediatric patients with perennial rhinitis, evaluated in a multidisciplinary allergy and otolaryngology clinic. Results obtained by standard history, validated sinus and Nasal Quality of Life Survey (SN-5), epicutaneous allergy testing, acoustic rhinometry, and sinus CT were compared.
  
  
  RESULTS
  Nasal congestion was the most frequent primary presenting complaint (62%). Among subjects having a positive allergy test, associated eye symptoms were more frequent (p = 0.01) and responses to the SN-5 allergic domain were higher (p = 0.02). Sinus CT scores were similar among allergic and nonallergic subjects (median 7 and 8, respectively) and did not correlate with symptom scores (p = 0.6). Among nonallergic subjects, quality of life ratings weakly correlated with sinus CT scores (r = 0.4; p = 0.05). By rhinometry, absolute mean cross-sectional area was similar among allergic (0.32 cm(2)) and nonallergic (0.36 cm(2)) subjects and did not correlate with symptom scores (p = 0.8 for allergic and p = 0.6 for nonallergic subjects). Distinct groups of nonallergic patients including those with prominent conjunctival pruritus (n = 24), frequent cold symptoms (n = 3), and chronic sinus disease (n = 2) were observed.
  
  
  CONCLUSIONS
  It is difficult to distinguish allergic and nonallergic rhinitis in patients with perennial disease, but associated eye symptoms and questionnaire responses are predictive of allergy. Acoustic rhinometry and sinus CT suggest that physical obstruction and sinus disease are not related to nasal symptoms including, surprisingly, the sensation of congestion.
authors.affiliation: Center for Innovation in Pediatric Practice, Nationwide Children's Hospital, Columbus, Ohio 43205, USA. eae9m@virginia.edu
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Erwin
authors.forename: Russell A
authors.initials: RA
authors.lastname: Faust
authors.forename: Thomas A E
authors.initials: TA
authors.lastname: Platts-Mills
authors.forename: Larry
authors.initials: L
authors.lastname: Borish
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging* / Q000473:pathology; D011379:Prognosis; D012220:Rhinitis / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D023842:Rhinometry, Acoustic; D012882:Skin Tests; D014057:Tomography, X-Ray Computed