Determinants of allergic rhinitis in young children with asthma.
BACKGROUND
In the preschool period, allergic rhinitis (AR) is infrequent and thus under-diagnosed. However, recent works have highlighted the occurrence of AR in toddlers although the causes of AR in this young population remain unknown. The objective of this study was to identify determinants of AR in young children with asthma.


METHODS
We carried out a case-control study of 227 children with active asthma and enrolled in the Trousseau Asthma Program. AR and other allergic diseases (asthma, food allergy and eczema) were diagnosed by medical doctors using standardized questionnaires. Parental history of AR and asthma, biological markers of atopy (total IgE, blood eosinophilia, allergic sensitization towards food and aeroallergens) and environmental parameters were also collected.


RESULTS
Forty one of the children (18.1%) had AR. By univariate logistic regression analysis, AR was mainly associated with peanut sensitization (OR = 6.75; p = 0.002); food allergy (OR = 4.31; p = 0.026); mold exposure (OR = 3.81 p<0.01) and parental history of AR (OR = 1.42; p = 0.046). Due to the strong link between food allergy and peanut sensitization three models of multivariate logistic regression were performed and confirmed that AR is associated with peanut sensitization but also food allergy and mold exposure. A random forest analysis was also performed to explain AR. The results reinforced the logistic analysis that peanut sensitization and mold exposure were the principal determinants of AR.


CONCLUSIONS
These results stress the importance of investigating AR in young children with asthma to potentially diagnose a particularly severe allergic asthmatic phenotype. Moreover, these data evoke the hypothesis that peanut could be an aeroallergen.
Allergology department, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau (Assistance Publique Hôpitaux de Paris) - Université Pierre et Marie Curie, Paris, France.
Lise
L
Moussu
Laboratoire de Statistiques Théoriques et Appliquées, Université Pierre et Marie Curie, Paris, France.
Philippe
P
Saint-Pierre
Allergology department, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau (Assistance Publique Hôpitaux de Paris) - Université Pierre et Marie Curie, Paris, France.
Virginie
V
Panayotopoulos
Service de Biochimie et Biologie Moléculaire, Hôpital d'Enfants Armand-Trousseau (Assistance Publique Hôpitaux de Paris), Paris, France.
Rémy
R
Couderc
Flore
F
Amat
Allergology department, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau (Assistance Publique Hôpitaux de Paris) - Université Pierre et Marie Curie, Paris, France.
Jocelyne
J
Just
D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000150:complications* / Q000175:diagnosis; D016022:Case-Control Studies; D002675:Child, Preschool; D004485:Eczema / Q000276:immunology; D004777:Environment; D005260:Female; D005512:Food Hypersensitivity / Q000276:immunology; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications / Q000276:immunology; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D065631:Rhinitis, Allergic / Q000150:complications* / Q000175:diagnosis; D012307:Risk Factors; D011795:Surveys and Questionnaires
D000485:Allergens