The proportion of local allergic rhinitis to Dermatophagoides pteronyssinus in children.
Local allergic rhinitis (LAR) is diagnosed by the positive response to nasal allergen provocation test (NAPT) to aeroallergen and/or local synthesis of specific IgE (sIgE). This entity is found in half of the adults with non-allergic rhinitis (NAR). In children, very few data of the prevalence and characteristics of LAR were reported.



Children 8-18 years with NAR were recruited. A NAPT with Dermatophagoides pteronyssinus extract (NAPT-Dp) at 200, 600, and 2000 AU/ml, respectively, at 15-min interval was performed. The immediate response was assessed using the clinical symptom score, peak nasal inspiratory flow (PNIF), and acoustic rhinometry (ARM). The nasal tryptase and sIgE-Dp were measured at baseline and 15 min and 1 h after a positive NAPT-Dp. Two allergic rhinitis (AR) patients were used as positive controls.



Fifty-four NAR children (61.1% boys) with the mean ± SD age of 11.1 ± 2.1 years were enrolled. The median duration of disease was 6.3 years. The most frequent comorbidity was asthma (38.9%). Eighty-seven percent of patients had mild persistent severity. NAPT-Dp was positive in 2/54 (3.7%) of NAR children who had increased symptom score and decreased minimal cross-sectional area (MCA) on ARM as well as PNIF. However, there was no change in the nasal tryptase and sIgE-Dp. The control AR patients had positive NAPT-Dp and increased nasal tryptase at 15 min without the change of sIgE-Dp.



LAR is an uncommon condition in children. Further investigation in a large population of children with NAR is needed.
Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicines Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Pichittra
P
Buntarickpornpan
Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicines Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Jittima
J
Veskitkul
Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicines Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Punchama
P
Pacharn
Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicines Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Nualanong
N
Visitsunthorn
Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicines Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Pakit
P
Vichyanond
Division of Rhinology and Allergy, Department of Otolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Pongsakorn
P
Tantilipikorn
Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicines Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Orathai
O
Jirapongsananuruk
D000293:Adolescent; D000328:Adult; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000276:immunology*; D002648:Child; D015897:Comorbidity; D040002:Dermatophagoides pteronyssinus; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology*; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D009296:Nasal Cavity / Q000378:metabolism*; D009299:Nasal Provocation Tests; D015995:Prevalence; D023842:Rhinometry, Acoustic; D013147:Spirometry; D013785:Thailand / Q000453:epidemiology
D039741:Antigens, Dermatophagoides; D007073:Immunoglobulin E
Dermatophagoides pteronyssinus; Specific IgE; acoustic rhinometry; allergic rhinitis; children; local allergic rhinitis; nasal allergen provocation test; peak nasal inspiratory flow; tryptase