Allergy Asthma Immunol Res.  2017 Jul;9(4):314-321. 10.4168/aair.2017.9.4.314.

Allergic Rhinitis in Preschool Children and the Clinical Utility of FeNO

• Yoon J
• Choi YJ
• Lee E
• Cho HJ
• Yang SI
• Kim YH
• Jung YH
• Seo JH
• Kwon JW
• Kim HB
• Lee SY
• Kim BS
• Shim JY
• Kim EJ
• Lee JS
• Hong SJ

• KMID: 2378194
• DOI: http://doi.org/10.4168/aair.2017.9.4.314

Abstract

PURPOSE
The nature of allergic rhinitis (AR) in preschool aged children remains incompletely characterized. This study aimed to investigate the prevalence of AR and its associated risk factors in preschool-aged children and to assess the clinical utility of fractional exhaled nitric oxide (FeNO).
METHODS
This general population-based, cross-sectional survey included 933 preschool-aged (3- to 7-year-old) children from Korea. Current AR was defined as having nasal symptoms within the last 12 months and physician-diagnosed AR.
RESULTS
The prevalence of current AR in preschool children was 17.0% (156/919). Mold exposure (adjusted odds ratio [aOR], 1.67; 95% confidence interval [CI], 1.15-2.43) and the use of antibiotics (aOR, 1.97; 95% CI, 1.33-2.90) during infancy were associated with an increased risk of current AR, whereas having an older sibling (aOR, 0.52; 95% CI, 0.35-0.75) reduced the risk. Children with current atopic AR had significantly higher geometric mean levels of FeNO compared to those with non-atopic rhinitis (12.43; range of 1standard deviation [SD], 7.31-21.14 vs 8.25; range of 1SD, 5.62-12.10, P=0.001) or non-atopic healthy children (8.58; range of 1SD, 5.51-13.38, P<0.001). The FeNO levels were higher in children with current atopic AR compared with atopic healthy children (9.78; range of 1SD, 5.97-16.02, P=0.083).
CONCLUSIONS
Mold exposure and use of antibiotics during infancy increases the risk of current AR, whereas having an older sibling reduces it. Children with current atopic AR exhibit higher levels of FeNO compared with non-atopic rhinitis cases, suggesting that FeNO levels may be a useful discriminatory marker for subtypes of AR in preschool children.

Keyword

Rhinitis; allergic; children; preschool; prevalence; risk factor; nitric oxide

MeSH Terms

Anti-Bacterial Agents
Child
Child, Preschool*
Cross-Sectional Studies
Fungi
Humans
Korea
Nitric Oxide
Odds Ratio
Prevalence
Rhinitis
Rhinitis, Allergic*
Risk Factors
Siblings
Anti-Bacterial Agents
Nitric Oxide

Figure

• 

  Fig. 1 The prevalence of all related AR questionnaires in 3- to 7-year-old children. AR, allergic rhinitis; sx., symptom; 12 mo., within 12 months; Dx., diagnosis; Tx., treatment.

• 

  Fig. 2 FeNO levels among children having current atopic AR without asthma along with those in atopic and non-atopic healthy children. FeNO, fractional exhaled nitric oxide; AR, allergic rhinitis; CI, confidence interval. *P<0.01.

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