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Influence of chronic diseases on the olfactory function in children


The association between smell impairment and chronic diseases has been reported in some studies in adults. Such information is not available for chronic diseases in children. The aim of this study was to examine olfactory function of children with chronic diseases such as diabetes mellitus type 1, hypothyroidism, and bronchial asthma in combination with allergic rhinitis in comparison to healthy controls. The data were obtained from n = 205 participants (104 boys, 101 girls) between the age of 6 and 17 years. Seventy-eight of the participants were healthy controls, n = 43 had diabetes mellitus type 1, n = 50 suffer from allergic rhinitis or bronchial asthma, and 34 presented a reduced function of their thyroid in medical history. All participants underwent olfactory testing including olfactory threshold using “Sniffin’ Sticks” and odor identification using the “U-Sniff” test. In addition, a depression inventory and cognitive testing using the Ravens Progressive Matrices was performed. No significant difference in olfactory function was observed for any of the chronic diseases in children in comparison to healthy controls. Further analysis showed a trend in significance for a subpopulation of children with bronchial asthma and comorbidities performed worse on the olfactory threshold test compared to patients with bronchial asthma without comorbidities. Pediatric patients suffering from chronic diseases scored higher on the depression inventory compared to healthy controls.

Conclusion: In conclusion, this study demonstrates that the influence of chronic diseases (bronchial asthma, diabetes mellitus type 1 and hypothyroidism) on olfactory function in childhood, if any, seems to be insignificant. This is partly in contrast to adult patients. Further research should be conducted in a subgroup of patients with bronchial asthma, allergic rhinitis, and atopic dermatitis or other comorbidities to better understand the association of allergic diathesis and olfactory function and the putative pathogenesis of olfactory dysfunction.

What is known:
• The association between smell impairment and chronic diseases has been reported in some studies in adults.
• Such information is not available for chronic diseases in children.
What is new:
• The influence of chronic diseases (bronchial asthma, diabetes mellitus type 1, and hypothyroidism) on olfactory function in childhood, if any, seems to be insignificant.
• In patients with bronchial asthma and allergic rhinitis, only a subgroup of patients with additional comorbidity (atopic dermatitis) showed a tendency to a reduced sense of smell.

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Colored progressive matrices


Degrees of freedom


Free triiodothyronine




Glycohemoglobin A1c


Multivariate variance analysis




Significance level


Correlation coefficient


Standard deviation


Standard progressive matrices


Statistical Package for the Social Sciences


Thyroid-stimulating hormone


universal Sniffin’ Sticks Test for children


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Funding was provided to VAS from the Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden (MedDrive) and the Else Kröner-Fresenius-Stiftung.

MLD received financial support from the Graduiertenakademie from the Technische Universität Dresden.

Author information

Janine Gellrich: author, data management, statistical analysis of the data.Marie-Luise Dabow: Recruitment of volunteers, data collection, data management, critical review. Christian Vogelberg: critical review and advice in relation to allergic rhinitis and asthma.Felix Reschke: critical review and advice in relation to endocrinological issues.Andrea Näke: critical review and advice in relation to diabetes.Maja von der Hagen: critical review and planning of the study.Valentin A. Schriever: planning of the study, statistical analysis, critical review.

Correspondence to Janine Gellrich.

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The study was conducted in accordance with the Declaration of Helsinki on Biomedical Studies Involving Human Subjects. The consent of all individuals involved in the study has been obtained after information. This article does not include studies with animals conducted by any of the authors.

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Gellrich, J., Dabow, M., Vogelberg, C. et al. Influence of chronic diseases on the olfactory function in children. Eur J Pediatr 178, 1185–1193 (2019). https://doi.org/10.1007/s00431-019-03380-1

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  • Olfactory threshold
  • Odor identification
  • “Sniffin’ sticks”
  • Chronic diseases children
  • Bronchial asthma
  • Allergic rhinosinusitis
  • Hypothyroidism
  • Diabetes mellitus type 1
  • Children