Abstract：
BACKGROUND: Local allergic rhinitis (LAR) is a condition involving a localized nasal allergic response in absence of systemic atopy. Most studies on LAR have been performed in adults. We aimed to describe clinical characteristics of LAR pediatric patients, its clinical evolution over a 7-year follow-up period and to study the role of basophil activation test (BAT), for its diagnosis.
METHODS: Forty-four children with non-allergic rhinitis (NAR) were included (24 males, 20 females, aged under 15 years). Nasal allergen provocation test (NAPT) and BAT were performed with Dermatophagoides pteronyssinus and Phleum pratense.
RESULTS: Seven patients (16%) were diagnosed of LAR. Six reacted to D pteronyssinus and one to P pratense. All LAR and 86% of NAR patients presented perennial symptoms. Fifty-seven percent of NAR and LAR patients referred persistent symptoms. Around half of NAR and LAR patients reported mild-moderate clinical manifestations. Three LAR patients associated conjunctival symptoms, proportionally more than NAR patients (19%, 7 out of 37). NAR patients presented bronchial asthma (n = 10) more frequently than LAR children (n = 1). More than half of LAR and NAR patients presented family history of atopy. BAT was negative in all LAR patients. On follow-up, 3 LAR patients and 10 of the 25 NAR patients who agreed to be retested, presented systemic sensitization. Dust mites were the most frequent allergen involved.
CONCLUSIONS: LAR should be ruled out in children with NAR. Almost half of children with LAR develop systemic sensitization over time. BAT shows low sensitivity for the diagnosis of LAR in children.
METHODS: Forty-four children with non-allergic rhinitis (NAR) were included (24 males, 20 females, aged under 15 years). Nasal allergen provocation test (NAPT) and BAT were performed with Dermatophagoides pteronyssinus and Phleum pratense.
RESULTS: Seven patients (16%) were diagnosed of LAR. Six reacted to D pteronyssinus and one to P pratense. All LAR and 86% of NAR patients presented perennial symptoms. Fifty-seven percent of NAR and LAR patients referred persistent symptoms. Around half of NAR and LAR patients reported mild-moderate clinical manifestations. Three LAR patients associated conjunctival symptoms, proportionally more than NAR patients (19%, 7 out of 37). NAR patients presented bronchial asthma (n = 10) more frequently than LAR children (n = 1). More than half of LAR and NAR patients presented family history of atopy. BAT was negative in all LAR patients. On follow-up, 3 LAR patients and 10 of the 25 NAR patients who agreed to be retested, presented systemic sensitization. Dust mites were the most frequent allergen involved.
CONCLUSIONS: LAR should be ruled out in children with NAR. Almost half of children with LAR develop systemic sensitization over time. BAT shows low sensitivity for the diagnosis of LAR in children.
摘要：
背景：局部过敏性鼻炎（LAR）是一种在没有全身性特应性的情况下涉及局部鼻过敏反应的疾病。大多数关于LAR的研究都是在成年人中进行的。我们旨在描述LAR儿科患者的临床特征，其在7年随访期间的临床演变，并研究嗜碱性粒细胞激活试验（BAT）的作用，为其诊断。
方法：纳入44名非过敏性鼻炎（NAR）患儿（24名男性，20名女性,15岁以下)。鼻部变应原激发试验（NAPT）和BAT用翼尘螨和回肠进行。
结果：7例患者（16%）被诊断为LAR。六个对蝶窦有反应，一个对蝶窦有反应。所有LAR和86％的NAR患者均出现常年性症状。57%的NAR和LAR患者表示持续的症状。大约一半的NAR和LAR患者报告轻度-中度临床表现。三名LAR患者相关的结膜症状，比例高于NAR患者(19%，37中的7个）。NAR患者出现支气管哮喘（n=10）的频率高于LAR儿童（n=1）。超过一半的LAR和NAR患者有特应性家族史。所有LAR患者的BAT均为阴性。关于后续行动，3名LAR患者和25名NAR患者中的10名同意重新测试，呈现全身致敏。尘螨是最常见的过敏原。
结论：应排除NAR患儿的LAR。随着时间的推移，几乎一半的LAR儿童会出现全身敏化。BAT对儿童LAR的诊断敏感性较低。
方法：纳入44名非过敏性鼻炎（NAR）患儿（24名男性，20名女性,15岁以下)。鼻部变应原激发试验（NAPT）和BAT用翼尘螨和回肠进行。
结果：7例患者（16%）被诊断为LAR。六个对蝶窦有反应，一个对蝶窦有反应。所有LAR和86％的NAR患者均出现常年性症状。57%的NAR和LAR患者表示持续的症状。大约一半的NAR和LAR患者报告轻度-中度临床表现。三名LAR患者相关的结膜症状，比例高于NAR患者(19%，37中的7个）。NAR患者出现支气管哮喘（n=10）的频率高于LAR儿童（n=1）。超过一半的LAR和NAR患者有特应性家族史。所有LAR患者的BAT均为阴性。关于后续行动，3名LAR患者和25名NAR患者中的10名同意重新测试，呈现全身致敏。尘螨是最常见的过敏原。
结论：应排除NAR患儿的LAR。随着时间的推移，几乎一半的LAR儿童会出现全身敏化。BAT对儿童LAR的诊断敏感性较低。
