Clinical Review

Allergic rhinitis in children

BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g4153 (Published 01 July 2014) Cite this as: BMJ 2014;349:g4153

This article has a correction. Please see:

  1. James G Barr, core surgical trainee,
  2. Hiba Al-Reefy, locum consultant rhinologist,
  3. Adam T Fox, consultant paediatric allergist,
  4. Claire Hopkins, consultant rhinologist
  1. 1Department of ENT surgery, Guy’s and St Thomas’ Hospitals NHS Foundation Trust, London SE1 9RT, UK
  1. Correspondence to: J G Barr jgbarr85{at}gmail.com

Summary points

  • Allergic rhinitis is an important and common condition that causes major morbidity in children and is a risk factor for the development of asthma

  • Nasal irrigation with saline is effective in children, improving symptoms, and reducing the need for drug treatment

  • Second generation H1 antihistamines are effective and safe for the treatment of allergic rhinitis and ocular symptoms in rhinoconjunctivitis

  • Modern intranasal glucocorticoids such as mometasone furoate and fluticasone propionate have not been found to impair growth; they can be used in children aged 6 years

  • Immunotherapy is the only treatment that can modify disease progress; it also has the potential to reduce the risk of asthma in patients with allergic rhinitis

Allergic rhinitis is a common paediatric condition. In a worldwide study of over one million adolescents aged 13 and 14 years the prevalence was 14.6%.1 Allergic rhinitis is characterised by rhinorrhoea, nasal obstruction, epiphora, and nasal itching. Many patients and parents think of seasonal, pollen induced “hay fever”; however, numerous aeroallergens may produce perennial symptoms, and these have an important impact on children’s quality of life.2 3 Evidence based guidelines, advances in drug treatments, and novel specific immunotherapy have all improved the management of allergic rhinitis. We review the current literature, with particular respect to the Allergic Rhinitis and its Impact on Asthma guidelines, produced by the World Health Organization.2

Sources and selection criteria

We searched Medline for randomised controlled trails, systematic reviews, and meta-analyses using the terms “allergic rhinitis” and “paediatrics”. We also reviewed the references used in the Allergic Rhinitis and its Impact on Asthma guidelines and consulted the Cochrane database of systematic reviews. Articles were included if all authors agreed on their relevance.

What is allergic rhinitis and why is it important?

Allergic rhinitis is an IgE mediated disorder triggered by exposure of nasal mucosa to allergens. This results in rhinorrhoea, itching, and sneezing as …

Sign in

Free trial

Register for a free trial to thebmj.com to receive unlimited access to all content on thebmj.com for 14 days.
Sign up for a free trial

Subscribe