Comorbidities and Phenotypes of Rhinitis in Korean Children and Adolescents: A Cross-sectional, Multicenter Study

Kyung Suk Lee; Hye Yung Yum; Youn Ho Sheen; Yong Mean Park; Yong Ju Lee; Bong Seok Choi; Hye Mi Jee; Sun Hee Choi; Hyun Hee Kim; Yang Park; Hyo Bin Kim; Yeong Ho Rha; Korean Academy of Pediatric Allergy and Respiratory Disease (KAPARD) Work Group on Rhinitis

doi:10.4168/aair.2017.9.1.70

Comorbidities and Phenotypes of Rhinitis in Korean Children and Adolescents: A Cross-sectional, Multicenter Study

Allergy Asthma Immunol Res. 2017 Jan;9(1):70-78. doi: 10.4168/aair.2017.9.1.70.

Affiliations

¹ Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
² Department of Pediatrics, Seoul Medical Center, Seoul, Korea.
³ Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea.
⁴ Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
⁵ Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
⁶ Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea.
⁷ Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
⁸ Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea.
⁹ Department of Pediatrics, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea.
¹⁰ Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea.
¹¹ Department of Pediatrics, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea. [email protected].

Abstract

Purpose: Rhinitis is a nasal inflammatory disease in children and adolescents. However, little is known about the phenotypes and characteristics of allergic rhinitis (AR) in Korean children and adolescents. The objective of this study was to analyze the symptoms and comorbidities of rhinitis, to compare AR to non-allergic rhinitis (NAR), and to reveal the phenotypes and features of AR in a Korean pediatric population.

Methods: Patients under 18 years of age with rhinitis symptoms were recruited from January 2013 to January 2015 by pediatric allergists. We analyzed symptoms, phenotypes, comorbidities, and allergen sensitization in this cross-sectional, multicenter study.

Results: Medical records were collected from 11 hospitals. The AR group has 641 (68.3%) patients, with 63.2% of boys and 7.5 (±3.4) years of mean age. The NAR group has 136 (14.5%) patients, with 55.1% of boys and 5.5 (±2.9) years of mean age. Moderate-severe persistent AR affected 41.2% of AR patients. Nasal obstruction was more common in NAR patients (P<0.050), whereas AR patients sneezed more (P<0.050) and more commonly had conjunctivitis, asthma, and otitis media (P<0.050). Sinusitis was the most common comorbidity in both groups. Allergen sensitization was caused by house dust mites (HDMs) (90.2%), pollen (38.7%), and animal dander (24.8%) in AR patients. Pollen and animal dander sensitization significantly increased age-dependently (P<0.050), but 91.9% of AR patients were already sensitized to HDMs before 5 years old.

Conclusions: Our study revealed that AR was more prevalent than NAR and that 41.2% of AR presented with moderate-severe disease in Korean pediatric populations. Sinusitis was the most common comorbidity, and sleep disturbance was associated with the severity of rhinitis. The majority of AR patients were sensitized to HDMs in preschool ages. Further studies, including nationwide and longitudinal data, will help understand the relationship between these diseases.

Keywords: Rhinitis; allergic rhinitis; children; comorbidity; phenotype.