Abstract：
Background. Local Allergic Rhinitis (LAR) is a phenotype defined by rhinitis symptoms with negative responses to systemic sensitization tests but with an exclusively nasal allergic inflammatory response. Data on the pediatric age group is scarce, and no Latin American data has been published so far. Methods. Nasal Allergen Challenge (NAC) was performed with Dermatophagoides pteronyssinus and Blomia tropicalis in six- to 18-year-old patients diagnosed with rhinitis and no systemic sensitization. NAC was monitored using subjective parameters and acoustic rhinometry. The study aimed to identify LAR in child and adolescent subjects previously diagnosed with non-allergic rhinitis (NAR) in a Brazilian specialty outpatient clinic (Allergy and Immunology). Results. During the study period, we analyzed 758 skin prick tests (SPT). Of those, 517 (68.2%) were diagnosed with rhinitis. Among those, 18.4% (95/517) had a negative SPT, meeting the criteria for inclusion in the study. Twenty-five patients underwent NAC, and 40% (10/25) of them, previously considered to have NAR, had a positive test and were reclassified as having LAR. Based on the analyzed characteristics, clinically differentiating LAR from NAR was impossible. Conclusions. This study represents the first investigation of LAR in child and adolescent subjects in Latin America, contributing significantly to the understanding of its prevalence and characteristics in this geographic area. Among a subgroup of patients lacking systemic sensitization submitted to NAC, 40% (10/25) demonstrated a positive NAC with Dermatophagoides pteronyssinus and Blomia tropicalis, warranting their reclassification to LAR. NAC with multiple allergens has been proven safe and viable in pediatric populations, affirming its critical role in the accurate diagnosis of LAR.
摘要：
■背景。局部过敏性鼻炎（LAR）是一种由鼻炎症状定义的表型，对全身致敏试验具有阴性反应，但具有专门的鼻过敏性炎症反应。儿科年龄组的数据很少，到目前为止还没有发布拉丁美洲的数据。方法。在诊断为鼻炎且无全身敏化的6至18岁患者中，用翼状尘螨和热带布洛姆进行了鼻过敏原攻击（NAC）。使用主观参数和声学鼻测监测NAC。该研究旨在确定在巴西专业门诊（过敏和免疫学）中先前诊断为非过敏性鼻炎（NAR）的儿童和青少年受试者的LAR。结果。在学习期间,我们分析了758个皮肤点刺试验（SPT）。其中,517（68.2％）被诊断为鼻炎。其中,18.4%(95/517)的SPT为阴性，符合纳入研究的标准。25名患者接受了NAC,其中40%(10/25)，以前被认为有NAR，测试呈阳性，被重新分类为有LAR。根据分析的特点，临床上不可能区分LAR和NAR。Conclusions.这项研究代表了拉丁美洲儿童和青少年受试者的首次LAR调查，大大有助于理解其在该地理区域的流行和特征。在接受NAC治疗的缺乏全身敏化的患者亚组中，40％（10/25）表现为翼状尘螨和热带盲症的NAC阳性，保证将其重新分类为LAR。具有多种过敏原的NAC已被证明在儿科人群中安全可行，肯定其在LAR的准确诊断中的关键作用。
