Allergic rhinitis in a child: symptoms and treatment
The content of the article:
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Types of allergic rhinitis
Allergic rhinitis in children: ICD-10 code
- Causes of allergic rhinitis in children
- Symptoms of allergic rhinitis in a child
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Treatment of allergic rhinitis in children
- Antihistamines
- Topical glucocorticosteroids
- Antileukotrienes
- Immunotherapy
- Video
Symptoms of allergic rhinitis in children can vary in severity. Adequate therapy should be prescribed by an allergist. An important point is compliance with the clinical recommendations of the doctor.
Allergic rhinitis is an inflammation of the nasal mucosa, which develops as a result of its contact with various allergens.
The severity and duration of the symptoms of the disease in children is determined by the allergen and the response to the treatment
The disease can be intermittent or persistent. In the first case, it lasts 4 or less days a week, or 4 or less weeks a year, in the second, the symptoms develop more often or last longer than the specified period.
Types of allergic rhinitis
There are two types of rhinitis:
- seasonal (hay fever) - the most common form that occurs against the background of a seasonal increase in the content of allergens in the environment. As a rule, it is noted in children over 6 years old;
- year-round - the reasons for its development are allergens that are constantly in the environment. It is often diagnosed in young children.
The basis of the pathology is an immediate-type allergic reaction that occurs upon contact with an allergen. Sharp odors, cold air and other factors can lead to the development of exacerbations.
Allergic rhinitis in children: ICD-10 code
The International Classification of Diseases 10th Revision (ICD-10) was developed by the World Health Organization to code medical diagnoses.
In accordance with ICD-10, allergic rhinitis belongs to class X - respiratory diseases, heading - other diseases of the upper respiratory tract and tumors, codes from J30 to J30.4, namely:
- vasomotor and allergic rhinitis - J30;
- allergic rhinitis caused by pollen (hay fever, pollinosis) - J30.1;
- other seasonal allergic rhinitis - J30.2;
- other allergic rhinitis - J30.3;
- allergic rhinitis, unspecified J30.4.
Causes of allergic rhinitis in children
The appearance of a disease in a baby may be associated with a hereditary predisposition to allergic diseases. A family history often includes bronchial asthma, allergic urticaria, diffuse neurodermatitis and other atopic pathologies diagnosed in one or more family members.
The most common cause of hay fever is grass and plant pollen.
Most often, hay fever develops due to pollen from trees and grasses of the Asteraceae, haze, or grasses. Also, fungal spores can be the cause of its occurrence. The appearance of poplar fluff coincides with the flowering of plants, the pollen of which provokes rhinitis. Pooh actively collects pollen on itself and carries it to those places where it would not fly.
The seasonality of the annual development of pronounced clinical manifestations of allergic rhinitis after its asymptomatic or erased course depends on the climatic characteristics of the region in which the child lives, and practically does not change from year to year.
Allergies can develop from contact with mold
The year-round form occurs in children who are in frequent contact with allergens at home or in their environment. These include: wool and particles of the epidermis of domestic animals, various chemical compounds, mold, household dust containing micro mites. Symptoms occur throughout the year and may worsen regardless of the season.
Symptoms of allergic rhinitis in a child
The characteristic manifestations of the disease include:
- prolonged sneezing attacks that appear in the morning upon contact with an allergen;
- persistent nasal congestion;
- watery discharge from the nasal cavity;
- watery eyes and discomfort in the eyes;
- persistent itching in the nose, throat, eyes and / or ears;
- decreased sense of smell and loss of taste (in the chronic course of the disease).
The mucous membrane of the nose with allergic rhinitis becomes pale and loose. In some cases, there is redness of the conjunctiva, slight or moderate hyperemia.
Prolonged allergic rhinitis can lead to polyps in the nose
Blockage of the paranasal sinuses in the year-round form of the disease leads to swelling of the nasal mucosa, which is accompanied by the addition of a secondary infection. The prolonged course of pathology often leads to the formation of polyps in the nasal cavity, the development of otitis media and sinusitis. Polyps further clog the openings of the paranasal sinuses, making breathing more difficult and worsening the symptoms of associated sinusitis.
Against the background of the disease, children may experience insomnia, irritability, decreased concentration, and other neurological disorders. Recurrence of ear infections, the development of bleeding in the nose and ears due to regular itching, conjunctivitis, peeling of the skin in the paranasal region, the formation of dark circles and folds under the eyes are also possible.
Constant nasal congestion causes the baby to breathe primarily through the mouth. For this reason, the functions of the nasal cavity - purification and heating of the air - are not performed, and a stream of dirty air enters the body. In the absence of timely therapy, a persistent runny nose can lead to asthma.
Treatment of allergic rhinitis in children
After confirming the diagnosis, the allergist determines how and how to treat allergic rhinitis, taking into account the medical history, age and general health of the child. Preventive measures to reduce patient exposure to allergy pathogens are of paramount importance. In order to determine which type of allergens causes inflammation, allergy tests are necessary.
With allergic rhinitis, it is necessary to pay sufficient attention to the prevention of the disease
The most difficult thing is to avoid contact with natural sources of the disease. During the flowering period of plants, it is important to limit the child from their direct impact: exclude walks on windy days, after a thunderstorm, in places where there is freshly cut grass, use sunglasses, and close the windows when driving in a car. Dr. Komarovsky recommends daily wet cleaning in a house where there is an allergy sufferer.
Along with preventive measures, drug therapy is the most effective both for blocking allergic response and reducing inflammation, and for improving the quality of life of a child. Self-medication or the use of folk remedies without first consulting a specialist may worsen the condition.
Antihistamines
Most often, antihistamines are prescribed for patients with allergic rhinitis. Their action is to competitively block the histamine receptors in the body, thereby inhibiting the effects mediated by them. Histamine is a neurotransmitter that affects the respiratory tract - it causes bronchospasm and swelling of the nasal mucosa. Allergic reactions increase its effect, therefore, to eliminate them, antihistamines from the group of H 1 -blockers are used. These include Fexofenadine, Loratadine, Cetirizine, Hydroxyzine and Diphenhydramine.
Loratadine is one of the commonly used antihistamines
Taking antihistamines relieves itching, eliminates a runny nose, cough and sneezing. According to reviews, the most common side effect of these drugs is drowsiness, which requires adjustment of the dosage regimen. For young children, antihistamines are prescribed in the form of a syrup, for older children - in tablets. It is possible to use funds in the form of nasal sprays and eye drops.
Topical glucocorticosteroids
In addition to topical antihistamines, steroids in the form of sprays or drops are prescribed for children with hay fever to control nasal inflammation and relieve eye symptoms. Their therapeutic effect is manifested after a few days, so the beginning of the use of such drugs should occur some time before the flowering season.
When using local glucocorticosteroids, nosebleeds may develop
Sometimes when spraying the product, nosebleeds are noted. Its development is not associated with the method of application of the spray, but is the result of the inflammatory process. Only in cases of heavy or prolonged bleeding is it necessary to consult a doctor for the selection of another dosage form of glucocorticosteroids.
When eye complications appear against the background of allergic rhinitis, the use of eye drops is most effective. Like nasal sprays, it's best to start using them some time before the flowering season. Many drops contain cromoglycate, which works to block cells that release histamine.
Drops are used conjunctivally - they are buried in the lower conjunctival sac of the eye. For younger children, it is better to carry out the procedure while lying down, holding the head, older children - in a sitting position with their head thrown back.
Topical glucocorticosteroids prescribed for children include:
- Fliksonase - dosed nasal spray, used from 4 years;
- Sofradex is a glucocorticosteroid in combination with an antibiotic in the form of eye drops. Used in older children;
- Nasonex is a dosed nasal spray, prescribed for children from 2 years of age.
Antileukotrienes
Often, allergic rhinitis is a concomitant disease of bronchial asthma and, if isolated, increases the risk of its development. Antileukotrienes are used to control asthma symptoms by helping to constrict the lungs and reduce the likelihood of fluid buildup. Clinical studies of such drugs have shown their effectiveness in monotherapy for hay fever, comparable to that when using new generation antihistamines.
Children can be prescribed Montelukast as part of a comprehensive treatment.
For mild allergic rhinitis, Montelukast may be the drug of choice. It helps to improve the quality of life in children with signs of rhinoconjunctivitis. Its use is also justified in cases of bronchial asthma, accompanied by allergic rhinitis.
The drug is available in two forms - film-coated tablets and chewable tablets. Montelukast can be used in children from 6 years of age, following the clinical recommendations of the doctor.
Immunotherapy
To improve the effect of drugs prescribed for the treatment of allergic rhinitis, and to strengthen the child's body during the period of manifestation of symptoms of the disease, immunotherapy is used. Its action is aimed at changing the immune system so that it does not react to allergens as a threat. The most common method is subcutaneous injection with an allergen. They allow you to gradually reduce the body's sensitivity to their effects and, over time, reduce the manifestation of the symptoms of the disease.
Immunotherapy is effective for allergies to mold, animal dander, dust mites and cockroaches, pollen from trees, grasses, ragweed. This type of treatment is carried out under the supervision of a physician and only in adolescents.
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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