title: The development of allergic rhinitis in children previously diagnosed as nonallergic rhinitis.
abstract: BACKGROUND
  Nonallergic rhinitis (NAR) is characterized by nasal symptoms similar to allergic rhinitis (AR) without an IgE-mediated immune response. Limited data are available on the natural history of NAR in its progression toward AR, particularly in children. This study  evaluates the development of AR in children who were previously diagnosed with NAR.
  
  
  METHODS
  Children with the diagnosis of NAR during the period of 2005-2007 were reevaluated in 2010. Nasal symptoms, disease severity, comorbidities, rescue medication scores (RMSs),  and skin-prick test to aeroallergens were assessed.
  
  
  RESULTS
  We recruited 175 children with an early diagnosis of NAR. The median age was 5.7 years, 62.9% were boys and 45.7% had family history of atopy. At reevaluation, 41% of children with previously diagnosed NAR developed  sensitization to aeroallergens and were reclassified as having AR. The most frequent aeroallergen sensitization was Dermatophagoides pteronyssinus (59.7%), followed by Dermatophagoides farinae (54.2%) and American cockroach (38.9%). Children who developed AR had more nasal/eye  symptoms, higher severity, and RMSs than children who did not develop AR. The predictors of developing AR were persistent nasal symptoms (adjusted odds ratio [OR], 8.9; 95% CI, 3.2-24.6), nasal itching (adjusted OR, 3.4; 95% CI, 1.2-9.5), triggered by house dust (adjusted OR,  4.3; 95% CI, 1.6-11.9) and animal danders (adjusted OR, 15.8; 95% CI, 3.3-76.1), and family history of atopy (adjusted OR, 6.0; 95% CI, 2.3-15.9).
  
  
  CONCLUSIONS
  Children with NAR who had family history of atopy, persistent nasal symptoms, and symptoms  triggered by aeroallergens should be reevaluated periodically for the development of AR. This study was part of the clinical trial NCT01068808 registered in www.clinicaltrials.gov.
authors: Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors: Jittima
authors: J
authors: Veskitkul
authors: Pakit
authors: P
authors: Vichyanond
authors: Nualanong
authors: N
authors: Visitsunthorn
authors: Orathai
authors: O
authors: Jirapongsananuruk
mesh_terms: D039741:Antigens, Dermatophagoides / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006801:Humans; D007114:Immunization; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008991:Monitoring, Physiologic; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012220:Rhinitis / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D012882:Skin Tests
chemical_list: D039741:Antigens, Dermatophagoides; D007073:Immunoglobulin E