rhinitis%20-%20nonallergic%20(pediatric)
RHINITIS - NONALLERGIC (PEDIATRIC)
Rhinitis is the inflammation of the nasal lining membranes.
Nonallergic rhinitis is a diagnosis of rhinitis without any immunoglobulin E (IgE) mediation, as documented by allergen skin testing.
Signs & symptoms are nasal itching, rhinorrhea, nasal congestion with or without obstruction and sneezing.

Diagnosis

  • A detailed clinical history & physical exam should be obtained to rule out other nasal conditions that may mimic signs & symptoms of rhinitis

History

  •  Nasal congestion and postnasal drip are the more common presenting symptoms compared to allergic rhinitis
  • Previous negative allergy testing
  • Sensitivity to smoke, perfume, environmental irritants & changes in weather conditions
  • Overuse of topical decongestants
  • Nasal crusting or drying
  • Facial pain

Physical Examination

Nasal Exam
  • Can be carried out using a nasal speculum (anterior rhinoscopy) or by endoscopy
    • Endoscopy is indicated when symptoms persist despite treatment; for assessment of nasal perforations, ulceration & polyps
  • May reveal the following:
    • Mucosa may be edematous, hyperemic or pale
    • Swollen nasal turbinates (note size & color)
    • Rhinorrhea with clear, cloudy or colored discharge
      • Bacterial sinusitis is considered if colored discharge is noted
    • Mouth breathing especially in chronic congestion
  • Patient should be referred to a specialist if findings are more consistent with a structural etiology than rhinitis (eg tumors, nasal polyps, septal deviation, adenoidal hypertrophy, etc)
Other physical findings may include:
  • Enlarged tonsils
  • Lymphadenopathy
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
19 Jun 2019
Acquired immunodeficiency syndrome (AIDS) remains as one of the world’s leading causes of mortality in global public health. Dr Charles Hicks shared his insights into the increasing role of dolutegravir (DTG; Tivicay, GSK) – an integrase strand transfer inhibitor (INSTI) – in HIV therapy during the 4th National AIDS Conference 2018 at Swiss Garden International Hotel and Residences, Kuala Lumpur.
2 days ago
Monotherapy with tenofovir disoproxil fumarate increases virologic response for up to 240 weeks in pretreated patients with hepatitis B virus infection (HBV) who are resistant to entecavir and/or adefovir, a new study has found.
Elvira Manzano, 3 days ago
Long-term treatment with the interleukin-5 receptor alpha-directed cytolytic monoclonal antibody benralizumab led to long-term control of asthma, improvement in pulmonary function, and was safe in patients with severe eosinophilic asthma in the 2-year integrated analysis of the SIROCCO, CALIMA, and ZONDA pivotal studies plus the BORA extension study reported at ATS 2019.
Pearl Toh, 15 hours ago
Patients with rheumatoid arthritis (RA) who maintained their disease remission had a significantly reduced risk of clinical and subclinical atherosclerosis, according to the 3-year follow-up data of the GIRRCS* study presented at EULAR 2019.