Pale nasal mucosa affects airflow limitations in upper and lower airways in asthmatic children.
BACKGROUND
Severe asthmatics are thought to have severer rhinitis than mild asthmatics. A pale nasal mucosa is a typical clinical finding in subjects with severe allergic rhinitis.


OBJECTIVE
The aim of this study was to investigate whether a pale nasal mucosa affects airflow limitations in the upper and lower airways in asthmatic children.


METHODS
Rhinomanometry, nasal scraping, and spirometry were performed in 54 asthmatic children (median age, 10 years). The nasal mucosa was evaluated by an otolaryngologist. Thirty-seven patients were treated with inhaled corticosteroids, and 11 patients were treated with intranasal corticosteroids.


RESULTS
Subjects with a pale nasal mucosa (n = 23) exhibited a lower nasal airflow (p< 0.05) and a larger number of nasal eosinophils (p< 0.05) in the upper airway as well as lower pulmonary functional parameters (p< 0.05 for all comparisons), i.e., the forced vital capacity (FVC), the forced expiratory volume in 1 second, and the peak expiratory flow, compared with the subjects who exhibited a normal or pinkish mucosa (n = 31). No significant difference in the forced expiratory flow between 25%-75% of the FVC, regarded as indicating the peripheral airway, was observed between the 2 groups.


CONCLUSIONS
A pale nasal mucosa may be a predictor of eosinophil infiltration of the nasal mucosa and central airway limitations in asthmatic children. When allergists observe a pale nasal mucosa in asthmatic children, they should consider the possibility of airflow limitations in not only the upper airway, but also the lower airway.
Department of Pediatrics, Fukuoka National Hospital, Fukuoka 811-1394, Japan.
Chikako
C
Motomura
Department of Pediatrics, Fukuoka National Hospital, Fukuoka 811-1394, Japan.
Hiroshi
H
Odajima
Yamada ENT Clinic, Fukuoka 815-0033, Japan.
Atsunobu
A
Yamada
Department of Pediatrics, Fukuoka National Hospital, Fukuoka 811-1394, Japan.
Naohiko
N
Taba
Department of Pediatrics, Fukuoka National Hospital, Fukuoka 811-1394, Japan.
Yoko
Y
Murakami
Department of Pediatrics, Fukuoka National Hospital, Fukuoka 811-1394, Japan.
Sankei
S
Nishima
Airflow limitation; Asthma; Eosinophils; Nasal obstruction; Rhinitis, allergic