Analysis of comorbid pathology in primary school children with allergic rhinitis

R.Ya. Meshkova1, A.E. Koroleva1, V.V. Bekezin1, O.S. Stunzhas2, I.N. Sergeeva1

1 Smolensk State Medical University, Smolensk, Russia;
2 Department of the Smolensk region for health, Smolensk, Russia

ALLERGOLOGY AND IMMUNOLOGY IN PEDIATRICS, Volume 65 • Number 2 • June 2021, pp. 19-24
DOI: 10.24412/2500-1175-2021-2-19-24

Relevance. In recent years, there has been an increase in the prevalence of allergic rhinitis (AR) in children, which varies depending on the child’s age, region of residence, the presence of comorbid allergic diseases and other risk factors.
Purpose of the study. To study the nature of comorbid allergic diseases, their manifestation in children of 7–8 years of age with allergic rhinitis on the basis of the data of parental questionnaires.
Materials and methods. A survey of parents of first-graders in 3 schools in Smolensk, located in different districts of the city, was carried out. In total, 400 questionnaires were handed out, 379 (94,75%) were returned filled. The average age of children was 7.7±0.02 y.o. The questions in the questionnaire included physically verified diagnoses of allergic diseases, risk factors, heredity, age of children at the time of manifestation of an allergic disease, the presence of comorbid allergic diseases in children with AR. The questionnaire was approved at a meeting of the «Pediatrics» section of the Ethics Committee of the State Budgetary Educational Institution of Higher Professional Education of the SSMU of the Ministry of Health of the Russian Federation dated 25.03.2017. Statistical processing was performed using the Microsoft Excel software package and 95% confidence intervals.
Results. It was found that in a cohort of 7–8 year old children in Smolensk, the incidence of AR is 18.2%, atopic dermatitis — 11.9%, bronchial asthma — 2.9%, food allergy — 12.2%, insect allergy — 12.4%, allergic conjunctivitis — 3.97%, drug allergy — 15.6%, allergic contact dermatitis — 4.5%. Analysis of the data obtained in children with AR showed that the manifestation of year-round AR is mainly observed at the age of 2 to 5 years, and seasonal AR — from 3 to 5 years and older than 5 years. It has also been shown that multimorbidity is present, i.e. combination of AR with other allergic diseases; in particular, with atopic dermatitis in 47.8% of cases, bronchial asthma in 10.1%, food allergy in 30.4%, allergic conjunctivitis in 15.9%. One third of children with AR have comorbid diseases of a non-IgE-dependent or mixed mechanism, such as drug allergy, insect allergy, and every tenth child has allergic contact dermatitis. The manifestation of comorbid allergic diseases took place at different age periods, which indicates multimorbidity in children with allergic rhinitis.
Conclusion. The results of our study show that AR is the most common allergic disease in children of 7–8 years of age living in the city of Smolensk. In almost half of the cases, AR is characterized by multimorbidity. This fact must be taken into account when developing individual tactics for managing children with AR.

  1. International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis //Int Forum Allergy Rhinol. 2018 February; 8(2): p. 108–352. doi:10.1002/alr.22073
  2. Буйнова С.Н. Десятилетняя динамика распространенности аллергического ринита у детей в городе Иркутске //Медицинский совет, 2015, № 15. С. 59-61. [Bujnova S.N. Desyatiletnyaya dinamika rasprostranennosti allergicheskogo rinita u detej v gorode Irkutske //Medicinskij sovet, 2015. № 15. S. 59-61. (In Russ)]
  3. Suh M.J. et al. Chronological changes in rhinitis symptoms //Plos one. Jan. 17, 2019, p. 3–9.
  4. Mario-Sanches F. et al. Multimorbidities of pediatric allergic rhinitis //Curr Allergy Asthma Rep. 2019 Feb. 22; 19(2): 13. doi:10.1007/s11882-0190843-9
  5. Lemonnier N. et al. A novel whole blood gene signature for asthma, dermatitis, and rhinitis multimorbidity in children and adolescents //Allergy. 2020, Vol. 75, issue 12, p. 3248–3260.
  6. Davidson W.F. et al. Report from the National Institute of Allergy and Infectious Diseases workshop on “Atopic dermatitis and the atopic march: Mechanisms and interventions” //J Allergy Clin Immunol. 2019 March; 143(3): p. 894–913. doi:10.1016/j.jaci.2019.01.003
  7. Skoczylas D. et al. Importance of food allergy and food intolerance in allergic multimorbidity //Ann Agric Environ Med 2020, Sep. 11: 27(3); p. 413–417.
  8. Paller A.S. et al. The atopic march and atopic multimorbidity: many trajectories, many pathways //J Allergy Clin Immunol, 2019, Vol. 143, number 1, p. 46–55.

Meshkova RYa, Koroleva AE, Bekezin VV, Stunzhas OS, Sergeeva IN. Analysis of comorbid pathology in primary school children with allergic rhinitis. Allergology and Immunology in Pediatrics. 2021;2(65):19–24. (In Russ.)

For correspondense

Raisa Ya. Meshkova, MD, DSc, Head of Department of Clinical Immunology and Allergology, Smolensk State Medical University
ORCID: 0000-0002-7806-9484
Address: 214018, Krupskaya str., 28, Smolensk, Russia