BMJ  2007;335:985-988 (10 November), doi:10.1136/bmj.39365.617905.BE

Clinical Review

Allergic rhinoconjunctivitis in children

¹ Section of Allergology, Department of Internal Medicine, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, Netherlands, ² Princess Amalia Children's Clinic, Isala Klinieken, PO Box 10400, 8000 GK, Zwolle, Netherlands, ³ Department of Otorhinolaryngology, Academic Medical Centre, PO Box 22700, 1100 DE, Amsterdam, Netherlands, ⁴ Department of General Practice, Erasmus MC

The first 150 words of the full text of this article appear below.

Allergic rhinoconjunctivitis is a common chronic disorder in children, especially in developed countries. It does not cause nasal symptoms only (such as congestion and sneezing) but may also cause general complaints such as fatigue and cough (box 1). It can also cause learning problems¹ and has a great impact on quality of life. Uncontrolled allergic rhinoconjunctivtis may aggravate the symptoms of asthma.² Although classic "hay fever" is easily recognised in children who have a runny nose, sneezing, and itchy eyes during the pollen season, the diagnosis of allergic rhinoconjunctivitis is often missed in children with perennial nasal congestion.

Box 1: Key symptoms of allergic rhinoconjunctivitis in children Nasal Blockage or congestion Watery discharge Sneezing Itching General Cough Fatigue, malaise, not feeling or looking well Sore throat, repeated throat clearing Halitosis, snoring, open mouth breathing

The term allergic rhinoconjunctivitis is preferable to allergic rhinitis because most patients also have ocular symptoms. In this review, we discuss the prevalence of allergic rhinoconjunctivitis in . . . [Full text of this article]

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SUMMARY POINTS

How many children are affected?

Which allergens are involved?

What is the differential diagnosis?

How is it diagnosed?

Physical examination
Tests for allergic sensitisation
Additional examinations

Quality of life

Box 2 Classification of allergic rhinoconjunctivitis in children⁸
Pattern of symptoms
Severity of symptoms
Mild
Moderate to severe

How is allergic rhinoconjunctivitis treated in children?

Is allergen avoidance useful?
Drugs
Intranasal glucocorticosteroids
Antihistamines
Other drugs
Tips for non-specialists
What is the status of immunotherapy in children?

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