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Multimorbidities of Pediatric Allergic Rhinitis

  • Rhinosinusitis (J Mullol, Section Editor)
  • Published:
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Abstract

Purpose of Review

Most children and adolescents with allergic rhinitis (AR) present extra-nasal multimorbid conditions, including conjunctivitis, asthma, atopic dermatitis, rhinosinusitis, or seromucous otitis. Additionally, they may present nasal obstructive disorders, such as septal deformity, turbinate enlargement, and adenoidal hyperplasia, which worsen nasal symptoms, especially nasal obstruction. This is a narrative review on the current state of the concomitant presence of AR and one or more multimorbidities.

Recent Findings

The presence of AR and one or more accompanying multimorbidities is associated to a higher severity and duration of the disease, a negative impact on quality of life, with worse control and lack of improvement with medical treatment. Therefore, AR needs to be managed with a multidisciplinary collaborative approach.

Summary

Pediatric AR needs to be considered in the context of a systemic disease, which requires a coordinated therapeutic strategy.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008;63(Suppl 86):8–160. https://doi.org/10.1111/j.1398-9995.2007.01620.x.

    Article  PubMed  Google Scholar 

  2. Nieto A, Mazon A, Martin-Mateos MA, Plaza AM, Garde J, Alonso E, et al. Pediatric allergy and immunology in Spain. Pediatr Allergy Immunol. 2011;22(7):742–50. https://doi.org/10.1111/j.1399-3038.2011.01211.x.

    Article  PubMed  Google Scholar 

  3. Ait-Khaled N, Pearce N, Anderson HR, Ellwood P, Montefort S, Shah J. Global map of the prevalence of symptoms of rhinoconjunctivitis in children: the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three. Allergy. 2009;64(1):123–48. https://doi.org/10.1111/j.1398-9995.2008.01884.x.

    Article  CAS  PubMed  Google Scholar 

  4. Ibanez MD, Valero AL, Montoro J, Jauregui I, Ferrer M, Davila I, et al. Analysis of comorbidities and therapeutic approach for allergic rhinitis in a pediatric population in Spain. Pediatr Allergy Immunol. 2013;24(7):678–84. https://doi.org/10.1111/pai.12126.

    Article  PubMed  Google Scholar 

  5. Pinart M, Benet M, Annesi-Maesano I, von Berg A, Berdel D, Carlsen KC, et al. Comorbidity of eczema, rhinitis, and asthma in IgE-sensitised and non-IgE-sensitised children in MeDALL: a population-based cohort study. Lancet Respir Med. 2014;2(2):131–40. https://doi.org/10.1016/s2213-2600(13)70277-7.

    Article  CAS  PubMed  Google Scholar 

  6. • Marino-Sanchez FS, Valls-Mateus M, Ruiz-Echevarria K, Alobid I, Cardenas-Escalante P, Jimenez-Feijoo R, et al. Nasal obstructive disorders induce medical treatment failure in paediatric persistent allergic rhinitis (the NODPAR Study). Pediatr Allergy Immunol. 2017;28(2):176–84. https://doi.org/10.1111/pai.12679 Real-life study about the impact of different intranasal anatomical conditions on allergic rhinitis severity and medical treatment response.

    Article  PubMed  Google Scholar 

  7. Kou W, Li X, Yao H, Wei P. Meta-analysis of the comorbidity rate of allergic rhinitis and asthma in Chinese children. Int J Pediatr Otorhinolaryngol. 2018;107:131–4. https://doi.org/10.1016/j.ijporl.2018.02.001.

    Article  PubMed  Google Scholar 

  8. Viñas Domingo M, Cardona Dahl V, Marin Molina AM, Eseverri Asin JL. Atopic dermatitis. Allergological characteristics and association with respiratory disease. Allergol Immunopathol (Madr). 2004;32(1):28–35.

    Article  Google Scholar 

  9. Cosickic A, Skokic F, Selimovic A, Mulic M, Suljendic S, Dedic N, et al. Development of respiratory allergies, asthma and allergic rhinits in children with atopic dermatitis. Acta Clin Croat. 2017;56(2):308–17. https://doi.org/10.20471/acc.2017.56.02.15.

    Article  PubMed  Google Scholar 

  10. Gray CL, Levin ME, Du Toit G. Respiratory comorbidity in South African children with atopic dermatitis. S Afr Med J. 2017;107(10):904–9. https://doi.org/10.7196/SAMJ.2017.v107i10.12418.

    Article  CAS  PubMed  Google Scholar 

  11. Pau BC, Ng DK. Prevalence of otitis media with effusion in children with allergic rhinitis, a cross sectional study. Int J Pediatr Otorhinolaryngol. 2016;84:156–60. https://doi.org/10.1016/j.ijporl.2016.03.008.

    Article  PubMed  Google Scholar 

  12. Gradman J, Wolthers OD. Allergic conjunctivitis in children with asthma, rhinitis and eczema in a secondary outpatient clinic. Pediatr Allergy Immunol. 2006;17(7):524–6. https://doi.org/10.1111/j.1399-3038.2006.00429.x.

    Article  PubMed  Google Scholar 

  13. Devillier P, Bousquet PJ, Grassin-Delyle S, Salvator H, Demoly P, Bousquet J, et al. Comparison of outcome measures in allergic rhinitis in children, adolescents and adults. Pediatr Allergy Immunol. 2016;27(4):375–81. https://doi.org/10.1111/pai.12561.

    Article  PubMed  Google Scholar 

  14. Valls-Mateus M, Marino-Sanchez F, Ruiz-Echevarria K, Cardenas-Escalante P, Jimenez-Feijoo R, Blasco-Lozano J, et al. Nasal obstructive disorders impair health-related quality of life in adolescents with persistent allergic rhinitis: a real-life study. Pediatr Allergy Immunol. 2017;28(5):438–45. https://doi.org/10.1111/pai.12724.

    Article  PubMed  Google Scholar 

  15. Friedlander JL, Sheehan WJ, Baxi SN, Kopel LS, Gaffin JM, Ozonoff A, et al. Food allergy and increased asthma morbidity in a school-based Inner-City Asthma Study. J Allergy Clin Immunol Pract. 2013;1(5):479–84. https://doi.org/10.1016/j.jaip.2013.06.007.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Cingi C, Muluk NB, Ulusoy S, Lopatin A, Sahin E, Passali D, et al. Septoplasty in children. Am J Rhinol Allergy. 2016;30(2):e42–7. https://doi.org/10.2500/ajra.2016.30.4289.

    Article  PubMed  Google Scholar 

  17. Cingi C, Gevaert P, Mösges R, Rondon C, Hox V, Rudenko M, et al. Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report. Clin Transl Allergy. 2017;7:17.

    Article  CAS  Google Scholar 

  18. Izquierdo-Dominguez A, Jauregui I, Del Cuvillo A, Montoro J, Davila I, Sastre J, et al. Allergy rhinitis: similarities and differences between children and adults. Rhinology. 2017;55(4):326–31. https://doi.org/10.4193/Rhin17.074.

    Article  CAS  PubMed  Google Scholar 

  19. Ciprandi G, Tosca MA, Signori A, Ameli F. Comparison between symptoms and endoscopy in children with nasal obstruction. Int J Pediatr Otorhinolaryngol. 2010;74(12):1405–8. https://doi.org/10.1016/j.ijporl.2010.09.019.

    Article  PubMed  Google Scholar 

  20. Shedden A. Impact of nasal congestion on quality of life and work productivity in allergic rhinitis: findings from a large online survey. Treat Respir Med. 2005;4(6):439–46.

    Article  Google Scholar 

  21. Mladina R, Cujic E, Subaric M, Vukovic K. Nasal septal deformities in ear, nose, and throat patients: an international study. Am J Otolaryngol. 2008;29(2):75–82. https://doi.org/10.1016/j.amjoto.2007.02.002.

    Article  PubMed  Google Scholar 

  22. Subaric M, Mladina R. Nasal septum deformities in children and adolescents: a cross sectional study of children from Zagreb, Croatia. Int J Pediatr Otorhinolaryngol. 2002;63(1):41–8.

    Article  Google Scholar 

  23. Guyuron B, Uzzo CD, Scull H. A practical classification of septonasal deviation and an effective guide to septal surgery. Plast Reconstr Surg. 1999;104(7):2202–9 discussion 10-2.

    Article  CAS  Google Scholar 

  24. Cole P. The four components of the nasal valve. Am J Rhinol. 2003;17(2):107–10.

    Article  Google Scholar 

  25. Marino-Sanchez F, Valls-Mateus M, Cardenas-Escalante P, Haag O, Ruiz-Echevarria K, Jimenez-Feijoo R, et al. Influence of nasal septum deformity on nasal obstruction, disease severity, and medical treatment response among children and adolescents with persistent allergic rhinitis. Int J Pediatr Otorhinolaryngol. 2017;95:145–54. https://doi.org/10.1016/j.ijporl.2017.02.005.

    Article  PubMed  Google Scholar 

  26. Anderson K, Ritchie K, Chorney JM, Bezuhly M, Hong P. The impact of septoplasty on health-related quality of life in paediatric patients. Clin Otolaryngol. 2016;41(2):144–8. https://doi.org/10.1111/coa.12485.

    Article  CAS  PubMed  Google Scholar 

  27. Tasca I, Compadretti GC. Nasal growth after pediatric septoplasty at long-term follow-up. Am J Rhinol Allergy. 2011;25(1):e7–12. https://doi.org/10.2500/ajra.2011.25.3536.

    Article  PubMed  Google Scholar 

  28. Farmer SE, Eccles R. Chronic inferior turbinate enlargement and the implications for surgical intervention. Rhinology. 2006;44(4):234–8.

    CAS  PubMed  Google Scholar 

  29. Dowley AC, Homer JJ. The effect of inferior turbinate hypertrophy on nasal spray distribution to the middle meatus. Clin Otolaryngol Allied Sci. 2001;26(6):488–90.

    Article  CAS  Google Scholar 

  30. Chhabra N, Houser SM. Surgical options for the allergic rhinitis patient. Curr Opin Otolaryngol Head Neck Surg. 2012;20(3):199–204. https://doi.org/10.1097/MOO.0b013e328352b821.

    Article  PubMed  Google Scholar 

  31. Parthasarathi K, Christensen JM, Alvarado R, Barham HP, Sacks R, Harvey RJ. Airflow and symptom outcomes between allergic and non-allergic rhinitis patients from turbinoplasty. Rhinology. 2017;55(4):332–8. https://doi.org/10.4193/Rhin16.210.

    Article  CAS  PubMed  Google Scholar 

  32. Arganbright JM, Jensen EL, Mattingly J, Gao D, Chan KH. Utility of inferior Turbinoplasty for the treatment of nasal obstruction in children: a 10-year review. JAMA Otolaryngol Head Neck Surg. 2015;141(10):901–4. https://doi.org/10.1001/jamaoto.2015.1560.

    Article  PubMed  Google Scholar 

  33. Crotty S. Follicular helper CD4 T cells (TFH). Annu Rev Immunol. 2011;29:621–63. https://doi.org/10.1146/annurev-immunol-031210-101400.

    Article  CAS  PubMed  Google Scholar 

  34. Zhang X, Sun B, Li S, Jin H, Zhong N, Zeng G. Local atopy is more relevant than serum sIgE in reflecting allergy in childhood adenotonsillar hypertrophy. Pediatr Allergy Immunol. 2013;24(5):422–6. https://doi.org/10.1111/pai.12089.

    Article  PubMed  Google Scholar 

  35. Evcimik MF, Dogru M, Cirik AA, Nepesov MI. Adenoid hypertrophy in children with allergic disease and influential factors. Int J Pediatr Otorhinolaryngol. 2015;79(5):694–7. https://doi.org/10.1016/j.ijporl.2015.02.017.

    Article  PubMed  Google Scholar 

  36. Ameli F, Brocchetti F, Tosca MA, Signori A, Ciprandi G. Adenoidal hypertrophy and allergic rhinitis: is there an inverse relationship? Am J Rhinol Allergy. 2013;27(1):e5–10. https://doi.org/10.2500/ajra.2013.27.3854.

    Article  PubMed  Google Scholar 

  37. Dogru M, Evcimik MF, Calim OF. Does adenoid hypertrophy affect disease severity in children with allergic rhinitis? Eur Arch Otorhinolaryngol. 2017;274(1):209–13. https://doi.org/10.1007/s00405-016-4196-x.

    Article  PubMed  Google Scholar 

  38. Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, et al. European position paper on rhinosinusitis and nasal polyps 2012. Rhinol Suppl. 2012:23 3 p preceding table of contents, 1–298.

  39. Badr DT, Gaffin JM, Phipatanakul W. Pediatric rhinosinusitis. Curr Treat Options Allergy. 2016;3(3):268–81. https://doi.org/10.1007/s40521-016-0096-y.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Veling MC. The role of allergy in pediatric rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 2013;21(3):271–6. https://doi.org/10.1097/MOO.0b013e32835fb399.

    Article  PubMed  Google Scholar 

  41. Gutman M, Torres A, Keen KJ, Houser SM. Prevalence of allergy in patients with chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2004;130(5):545–52. https://doi.org/10.1016/j.otohns.2004.02.007.

    Article  PubMed  Google Scholar 

  42. Gelincik A, Buyukozturk S, Aslan I, Aydin S, Ozseker F, Colakoglu B, et al. Allergic vs nonallergic rhinitis: which is more predisposing to chronic rhinosinusitis? Ann Allergy Asthma Immunol. 2008;101(1):18–22. https://doi.org/10.1016/s1081-1206(10)60829-0.

    Article  PubMed  Google Scholar 

  43. Halderman AA, Tully LJ. The role of allergy in chronic rhinosinusitis. Otolaryngol Clin N Am. 2017;50(6):1077–90. https://doi.org/10.1016/j.otc.2017.08.003.

    Article  Google Scholar 

  44. Nguyen KL, Corbett ML, Garcia DP, Eberly SM, Massey EN, Le HT, et al. Chronic sinusitis among pediatric patients with chronic respiratory complaints. J Allergy Clin Immunol. 1993;92(6):824–30.

    Article  CAS  Google Scholar 

  45. Iwens P, Clement PA. Sinusitis in allergic patients. Rhinology. 1994;32(2):65–7.

    CAS  PubMed  Google Scholar 

  46. Leo G, Piacentini E, Incorvaia C, Consonni D, Frati F. Chronic sinusitis and atopy: a cross-sectional study. Eur Ann Allergy Clin Immunol. 2006;38(10):361–3.

    CAS  PubMed  Google Scholar 

  47. Lin SW, Wang YH, Lee MY, Ku MS, Sun HL, Lu KH, et al. Clinical spectrum of acute rhinosinusitis among atopic and nonatopic children in Taiwan. Int J Pediatr Otorhinolaryngol. 2012;76(1):70–5. https://doi.org/10.1016/j.ijporl.2011.10.002.

    Article  PubMed  Google Scholar 

  48. • Leo G, Incorvaia C, Cazzavillan A, Consonni D, Zuccotti GV. Could seasonal allergy be a risk factor for acute rhinosinusitis in children? J Laryngol Otol. 2018;132(2):150–3. https://doi.org/10.1017/s0022215118000038 Study showing the association between allergic rhinitis and acute rhinosinusitis.

    Article  CAS  PubMed  Google Scholar 

  49. Stuck BA, Hummel T. Olfaction in allergic rhinitis: a systematic review. J Allergy Clin Immunol. 2015;136(6):1460–70. https://doi.org/10.1016/j.jaci.2015.08.003.

    Article  PubMed  Google Scholar 

  50. Langdon C, Guilemany JM, Valls M, Alobid I, Bartra J, Davila I, et al. Allergic rhinitis causes loss of smell in children: the OLFAPEDRIAL study. Pediatr Allergy Immunol. 2016;27(8):867–70. https://doi.org/10.1111/pai.12655.

    Article  PubMed  Google Scholar 

  51. Doty RL, Frye R. Influence of nasal obstruction on smell function. Otolaryngol Clin N Am. 1989;22(2):397–411.

    CAS  Google Scholar 

  52. Guilemany JM, Garcia-Pinero A, Alobid I, Cardelus S, Centellas S, Bartra J, et al. Persistent allergic rhinitis has a moderate impact on the sense of smell, depending on both nasal congestion and inflammation. Laryngoscope. 2009;119(2):233–8. https://doi.org/10.1002/lary.20075.

    Article  CAS  PubMed  Google Scholar 

  53. Mariño-Sanchez F, Valls-Mateus M, Haag O, Alobid I, Bousquet J, Mullol J. Smell loss is associated with severe and uncontrolled disease in children and adolescents with persistent allergic rhinitis. J Allergy Clin Immunol Pract. 2018;6(5):1752–1755.e3. https://doi.org/10.1016/j.jaip.2017.12.031.

    Article  PubMed  Google Scholar 

  54. Stachler RJ. Comorbidities of asthma and the unified airway. Int Forum Allergy Rhinol. 2015;5(Suppl 1):S17–22. https://doi.org/10.1002/alr.21615.

    Article  PubMed  Google Scholar 

  55. Plaza V, Rodriguez del Rio P, Gomez F, Lopez Vina A, Molina J, Quintano JA, et al. Identification of gaps in the clinical patient care of asthma in Spain. Results of the OPTIMA-GEMA survey. An Sist Sanit Navar. 2016;39(2):181–201. https://doi.org/10.23938/assn.0274.

    Article  CAS  PubMed  Google Scholar 

  56. Navarro A, Valero A, Julia B, Quirce S. Coexistence of asthma and allergic rhinitis in adult patients attending allergy clinics: ONEAIR study. J Investig Allergol Clin Immunol. 2008;18(4):233–8.

    CAS  PubMed  Google Scholar 

  57. Tran MM, Lefebvre DL, Dharma C, Dai D, Lou WYW, Subbarao P, et al. Predicting the atopic march: results from the Canadian Healthy Infant Longitudinal Development Study. J Allergy Clin Immunol. 2018;141(2):601–7.e8. https://doi.org/10.1016/j.jaci.2017.08.024.

    Article  PubMed  Google Scholar 

  58. Wu D, Bleier BS, Wei Y. Progression from nasal polyps to adult-onset asthma: a different process from atopic march? Rhinology online. 2018;1:22–9. https://doi.org/10.4193/RHINOL/18.006.

    Article  Google Scholar 

  59. Jamrozik E, Knuiman MW, James A, Divitini M, Musk AW. Risk factors for adult-onset asthma: a 14-year longitudinal study. Respirology. 2009;14(6):814–21. https://doi.org/10.1111/j.1440-1843.2009.01562.x.

    Article  PubMed  Google Scholar 

  60. Ciprandi G, Pronzato C, Ricca V, Passalacqua G, Bagnasco M, Canonica GW. Allergen-specific challenge induces intercellular adhesion molecule 1 (ICAM-1 or CD54) on nasal epithelial cells in allergic subjects. Relationships with early and late inflammatory phenomena. Am J Respir Crit Care Med. 1994;150(6 Pt 1):1653–9. https://doi.org/10.1164/ajrccm.150.6.7524984.

    Article  CAS  PubMed  Google Scholar 

  61. • Skylogianni E, Triga M, Douros K, Bolis K, Priftis KN, Fouzas S, et al. Small-airway dysfunction precedes the development of asthma in children with allergic rhinitis. Allergol Immunopathol (Madr). 2018;46(4):313–21. https://doi.org/10.1016/j.aller.2017.09.025 Study that suggests that identifying changes in respiratory impedance in children with allergic rhinitis might predict progression to asthma.

    Article  CAS  Google Scholar 

  62. Shaker M. New insights into the allergic march. Curr Opin Pediatr. 2014;26(4):516–20. https://doi.org/10.1097/mop.0000000000000120.

    Article  PubMed  Google Scholar 

  63. McAleer MA, Irvine AD. The multifunctional role of filaggrin in allergic skin disease. J Allergy Clin Immunol. 2013;131(2):280–91. https://doi.org/10.1016/j.jaci.2012.12.668.

    Article  CAS  PubMed  Google Scholar 

  64. Schleimer RP, Berdnikovs S. Etiology of epithelial barrier dysfunction in patients with type 2 inflammatory diseases. J Allergy Clin Immunol. 2017;139(6):1752–61. https://doi.org/10.1016/j.jaci.2017.04.010.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. •• Lowe AJ, Leung DYM, Tang MLK, Su JC, Allen KJ. The skin as a target for prevention of the atopic march. Ann Allergy Asthma Immunol. 2018;120(2):145–51. Excellent overview of atopic dermatitis and the potential to target the skin barrier as a means to reduce the incidence of allergic disease. https://doi.org/10.1016/j.anai.2017.11.023.

    Article  PubMed  Google Scholar 

  66. Van Cauwenberge P, Watelet JB, Van Zele T, Bousquet J, Burney P, Zuberbier T. Spreading excellence in allergy and asthma: the GA2 LEN (Global Allergy and Asthma European Network) project. Allergy. 2005;60(7):858–64. https://doi.org/10.1111/j.1398-9995.2005.00822.x.

    Article  PubMed  Google Scholar 

  67. Hom MM, Bielory L. The anatomical and functional relationship between allergic conjunctivitis and allergic rhinitis. Allergy Rhinol (Providence). 2013;4(3):e110–9. https://doi.org/10.2500/ar.2013.4.0067.

    Article  Google Scholar 

  68. Bielory L. Allergic conjunctivitis and the impact of allergic rhinitis. Curr Allergy Asthma Rep. 2010;10(2):122–34. https://doi.org/10.1007/s11882-010-0087-1.

    Article  PubMed  Google Scholar 

  69. Chafen JJ, Newberry SJ, Riedl MA, Bravata DM, Maglione M, Suttorp MJ, et al. Diagnosing and managing common food allergies: a systematic review. JAMA. 2010;303(18):1848–56. https://doi.org/10.1001/jama.2010.582.

    Article  PubMed  Google Scholar 

  70. Sicherer SH, Sampson HA. Food allergy: a review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol. 2018;141(1):41–58. https://doi.org/10.1016/j.jaci.2017.11.003.

    Article  CAS  PubMed  Google Scholar 

  71. Vega F, Panizo C, Dordal MT, Gonzalez ML, Velazquez E, Valero A, et al. Relationship between respiratory and food allergy and evaluation of preventive measures. Allergol Immunopathol (Madr). 2016;44(3):263–75. https://doi.org/10.1016/j.aller.2015.05.008.

    Article  CAS  Google Scholar 

  72. Asai Y, Greenwood C, Hull PR, Alizadehfar R, Ben-Shoshan M, Brown SJ, et al. Filaggrin gene mutation associations with peanut allergy persist despite variations in peanut allergy diagnostic criteria or asthma status. J Allergy Clin Immunol. 2013;132(1):239–42. https://doi.org/10.1016/j.jaci.2013.03.043.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Cheng X, Sheng H, Ma R, Gao Z, Han Z, Chi F, et al. Allergic rhinitis and allergy are risk factors for otitis media with effusion: a meta-analysis. Allergol Immunopathol (Madr). 2017;45(1):25–32. https://doi.org/10.1016/j.aller.2016.03.004.

    Article  CAS  Google Scholar 

  74. Roditi RE, Veling M, Shin JJ. Age: an effect modifier of the association between allergic rhinitis and otitis media with effusion. Laryngoscope. 2016;126(7):1687–92. https://doi.org/10.1002/lary.25682.

    Article  PubMed  Google Scholar 

  75. Lack G, Caulfield H, Penagos M. The link between otitis media with effusion and allergy: a potential role for intranasal corticosteroids. Pediatr Allergy Immunol. 2011;22(3):258–66. https://doi.org/10.1111/j.1399-3038.2010.01130.x.

    Article  PubMed  Google Scholar 

  76. Krouse JH, Veling MC, Ryan MW, Pillsbury HC 3rd, Krouse HJ, Joe S, et al. Executive summary: asthma and the unified airway. Otolaryngol Head Neck Surg. 2007;136(5):699–706.

    Article  Google Scholar 

  77. Juniper EF, Howland WC, Roberts NB, Thompson AK, King DR. Measuring quality of life in children with rhinoconjunctivitis. J Allergy Clin Immunol. 1998;101(2 Pt 1):163–70.

    Article  CAS  Google Scholar 

  78. Meltzer EO, Blaiss MS, Derebery MJ, Mahr TA, Gordon BR, Sheth KK, et al. Burden of allergic rhinitis: results from the Pediatric Allergies in America survey. J Allergy Clin Immunol. 2009;124(3 Suppl):S43–70. https://doi.org/10.1016/j.jaci.2009.05.013.

    Article  PubMed  Google Scholar 

  79. Camelo-Nunes IC, Sole D. Allergic rhinitis: indicators of quality of life. J Bras Pneumol. 2010;36(1):124–33.

    Article  Google Scholar 

  80. Juniper EF, Guyatt GH, Dolovich J. Assessment of quality of life in adolescents with allergic rhinoconjunctivitis: development and testing of a questionnaire for clinical trials. J Allergy Clin Immunol. 1994;93(2):413–23.

    Article  CAS  Google Scholar 

  81. Silva CH, Silva TE, Morales NM, Fernandes KP, Pinto RM. Quality of life in children and adolescents with allergic rhinitis. Braz J Otorhinolaryngol. 2009;75(5):642–9.

    Article  Google Scholar 

  82. Scadding GK. Optimal management of allergic rhinitis. Arch Dis Child. 2015;100(6):576–82. https://doi.org/10.1136/archdischild-2014-306300.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Macintyre S, Hunt K, Sweeting H. Gender differences in health: are things really as simple as they seem? Soc Sci Med. 1996;42(4):617–24.

    Article  CAS  Google Scholar 

  84. Kalpaklioglu AF, Baccioglu A. Evaluation of quality of life: impact of allergic rhinitis on asthma. J Investig Allergol Clin Immunol. 2008;18(3):168–73.

    CAS  PubMed  Google Scholar 

  85. Occasi F, Duse M, Vittori T, Rugiano A, Tancredi G, De Castro G, et al. Primary school children often underestimate their nasal obstruction. Rhinology. 2016;54(2):164–9. https://doi.org/10.4193/Rhin15.120.

    Article  PubMed  Google Scholar 

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Mariño-Sánchez, F., Valls-Mateus, M., de los Santos, G. et al. Multimorbidities of Pediatric Allergic Rhinitis. Curr Allergy Asthma Rep 19, 13 (2019). https://doi.org/10.1007/s11882-019-0843-9

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