Pediatr. praxi. 2008;9(2):110-118

Treatment of allergic rhinitis

MUDr. Jiří Novák
Oddělení dětí a dorostu, alergologie a klinická imunologie, Nemocnice Litomyšl

The principles of rhinitis allergica treatment in children are similar to those in adults; special care should be taken, to avoid the side effects of drugs. Non-pharmacologic treatment involves education of the family and the child about the nature of the disease and about the avoidance of allergens and irritants from the environment. Allergen specific subcutaneous immunotherapy is not usually recommended before the age of five years, sublingual immunotherapy in children with allergic rhinitis may possibly prevent later development of asthma. The evidence available from studies indicates that slowing of linear growth can occur in children treated with intranasal corticosteroids. There is a possibility of hypothalamic-pituitary-adrenal axis suppression by fluticason, beclomethasone and budesonide intranasal treatment which, however, does not appear clinically significant at most patients. Any child receiving topical corticosteroids should undergo regular monitoring of growth at 4-month intervals during the first year of treatment, and at 6-month intervals thereafter.

Key words: allergic rhinitis, allergen, intranasal corticosteroids, side effects.

Keywords: allergic rhinitis, allergen, intranasal corticosteroids, side effects

Published: May 15, 2008  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Novák J. Treatment of allergic rhinitis. Pediatr. praxi. 2008;9(2):110-118.
Download citation

References

  1. ARIA update. In collaboration with GA2LEN and AllerGen. 2007. www.whiar.org.
  2. Barnes PJ, Pedersen S, Busse WW. Efficacy and safety of inhaled corticosteroids, new developments. Am J Respir Crit Care Med 1998; 157: S1-S53. Go to original source... Go to PubMed...
  3. Van Bever HP, Desager KN, Lijssens N et al. Does treatment of asthmatic children with inhaled corticosteroids affect their adult height? Pediatr Pulmonol 1999; 27: 367-375. Go to original source...
  4. Bielory L, Blaiss M, Fineman MS, Ledford DK, Lieberman P, Simons FER, Skoner D. Position statement. Concerns about intranasal corticostroids for over-the-counter use: position statement of the Joint Task Force for the American Academy of Allergy, Asthma and Immunology and the American College of Allergy, Asthma and Immunology. J Alergy Clin Immunol 2006; 96: 514-524. Go to original source...
  5. Delay-Yates PT, Price AC. Sisson JR et al. Beclomethasone dipropionate: absolute bioavalability, pharmacocinetics and metabolism following intravenous, oral, intranasal and inhaled administration in man. Br J Clin Pharmacol 2001; 51: 400-409. Go to original source... Go to PubMed...
  6. FDA Division of Pulmonary Drug Products (1998). Class labeling for intranasal and orally inhaled corticosteroid containing drug products regarding the potential for growth suppression in children. U. S. Food and Drug Administration center for Drug Evaluation and Research Web site. Available at: www.fda.gov/cder/news/cs-label.htm. Accessed September 11, 2005.
  7. Hrubiško M, Barta T. Manažment alergickej nádchy/rinosinusitidy a jej komorbidit. 2007. Mediforum. Bratislava.
  8. Johansson SGO, Haahtela T. Prevention of allergy and allergic astma. Basel: Karger. Chemical Immunology and Allergy. 2005.
  9. Juniper EF, Stahl E, Doty RL et al. Clinical ourcomes and advers effect monitoring in allergic rhinitis. J Allergy Clin Immunol 2005; 115: 390-412. Go to original source... Go to PubMed...
  10. Kaliner MA et al. Current review of rhinitis. 2002. Current Medicine, Inc. Philadelphia.
  11. Khan DA. Over-the-counter intranasal corticosteroids: empowering the patient or putting them in harm´s way? Ann Allerg Asthma Immunol 2006; 96: 506-508. Go to original source... Go to PubMed...
  12. Knutsson U, Stierna P, Marcus C et al. Effects of intranasal glucocorticoids on endogenous glucocorticoid peripheral and central function. Journal of Endocrinology, 1996; 144: 301-310. Go to original source... Go to PubMed...
  13. Leung DYM, Szefler S et al. Pediatric allergy. 2003. Mosby. St. Louis.
  14. Murphy K, Uryniak T, Simpson B et al. Growth velocity in children with perrenial allergic rhinitis treated with budesonide aqueous nasal spray. Ann Allergy Asthma Immunol 2006; 96: 723-730. Go to original source... Go to PubMed...
  15. Novák J. Bezpečnost inhalačních kortikosteroidů - část II. Inhalační kortikosteroidy, astma a růst. Alergie 2007; 9: 20-31.
  16. Novák J. Bezpečnost inhalačních kortikosteroidů - část IV. Alergie 2007; 9, 251-258.
  17. Novák J. Primární prevence alergie a atmatu. Pediatr. pro Praxi 2007; 3: 144-146.
  18. Perry RJ, Findlay CA, Donaldson MDC. Cushing´s syndrome, growth impairment, and occult adrenal suppression associated with intranasal steroids. Arch Dis Child 2005; 256-259.
  19. Rachafelsky JS, Chervinsky P, Meltzer E et al. An evalution of the effects of beclomethasone dipropionate aqueous spray (Vancenase AQ) on long term growth in children (abstract). J Allergy Clin Immunol 1998: 101: S236.
  20. Seberová E. Alergická rýma. Praha: Maxdorf, 2006.
  21. Skoner DP, Rachafelsky GS, Meltzer EO et at. Detection of growth suppression in children during treatment with intranasal beclomethasone dipropionate. Pediatrics 2000; 105: E22-E28. Go to original source... Go to PubMed...
  22. Skoner DP, Gentile D, Angelini A et al. The effects of intranasal triamcinolone acetonide and intranasal fluticasone propionate on short term bone growth and HPA axis in children with allergic rhinitis. Ann Allergy Asthma Immunol 2003; 90: 56-62. Go to original source... Go to PubMed...
  23. Vokurka J. Kortikoidy u rinosinusitid. Alergie 2007; 9, suppl. 2: 37-42.
  24. Wihl JA, Andersson KE, Johansson SA. Systemic effects of two nasally administered glucocorticosteroids. Allergy 1997; 52: 620-626. Go to original source... Go to PubMed...
  25. Wilson AM, McFarlane LC, Lipworthe BJ. Effects of repeated once daily dosing of three intranasal corticosteroids on basal and dynamic measures of hypothalamic-pituitary-adrenal axis activity. J Allergy Clin Immunol 1998; 101: 470-474. Go to original source... Go to PubMed...
  26. Wolthers OD, Pedersen S. Short-term growth in children with allergic rhinitis treated with oral antihistamine, depot and intranasal glucocorticosteroids. Acta Paediatr 1993; 82: 635-640. Go to original source... Go to PubMed...




Pediatrics for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.