Predictive factors to differentiate between allergic and nonallergic rhinitis in children

Abstract

BACKGROUND: Although symptoms and signs of allergic rhinitis (AR) and nonallergic rhinitis (NAR) are similar, treatment and follow-up are different. We aimed to find predictive factors that can be used in primary health care to differentiate AR from NAR. METHODS: We made a retrospective analysis of cases aged 6-18 years old who were diagnosed as having chronic rhinitis within a 1-year period. Skin-prick tests were done and severity of rhinitis symptoms was recorded on a visual analog scale in all patients. RESULTS: There were 472 cases whose medical records were complete and included in the analysis. The median age was 11 (interquartile range [IQR], 5) years. AR was diagnosed in 363 patients (76.9%) and was different from NAR with respect to: median age (p = 0.042), seasonality of the symptoms (p = 0.002), persistent symptoms (p = 0.003), moderate/severe according to visual analogue scale (VAS) score (p = 0.017), conjunctivitis (p < 0.001), parental history of AR (p = 0.026), rhinorrhea (p < 0.001), sneezing (p = 0.005), mucosal pallor (p = 0.004), and response to antihistamines (p = 0.035). All parameters with a significance of p < 0.1 between AR and NAR were included in logistic regression analysis. Seasonality, sneezing, moderate/severe rhinitis, and response to antihistamines were identified as significant independent parameters to differentiate AR from NAR. CONCLUSION: Features of rhinitis patients with seasonality, sneezing, moderate/severe rhinitis, and response to antihistamines may help in differentiation of AR from NAR at the primary care level.