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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Dec 26, 2016; 6(4): 200-213
Published online Dec 26, 2016. doi: 10.5662/wjm.v6.i4.200
Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management
Dimitri Poddighe, Matteo Gelardi, Amelia Licari, Michele Miraglia del Giudice, Gian Luigi Marseglia
Dimitri Poddighe, Department of Pediatrics, ASST Melegnanoe Martesana, 20070 Milano, Italy
Dimitri Poddighe, Amelia Licari, Gian Luigi Marseglia, Department of Pediatric Sciences, Università degli Studi di Pavia, 27100 Pavia, Italy
Matteo Gelardi, Department of Otolaryngology, Università di Bari, 70121 Bari, Italy
Amelia Licari, Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
Michele Miraglia del Giudice, Department of Pediatrics, Seconda Università di Napoli, 80131 Napoli, Italy
Gian Luigi Marseglia, Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo di Pavia, 27100 Pavia, Italy
Author contributions: All the authors contributed to the manuscript.
Conflict-of-interest statement: The authors report no conflict of interest and have not received any honorarium, grant, or other form of payment to produce it.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Dimitri Poddighe, MD, Department of Pediatrics, ASST Melegnanoe Martesana, P.O. Vizzolo Predabissi, via Pandina 1, 20070 Milano, Italy. dimimedpv@yahoo.it
Telephone: +39-347-7241851 Fax: +39-029-8052438
Received: June 9, 2016
Peer-review started: June 14, 2016
First decision: July 29, 2016
Revised: September 18, 2016
Accepted: November 1, 2016
Article in press: November 3, 2016
Published online: December 26, 2016
Abstract

Chronic rhinitis is a very common disease, as the prevalence in the general population resulted to be 40%. Allergic rhinitis has been considered to be the most frequent form of chronic rhinitis, as non-allergic rhinitis has been estimated to account for 25%. However, several evidences suggested that non-allergic rhinitis have been underrated, especially in children. In pediatrics, the diagnostic definition of non-allergic rhinitis has been often limited to the exclusion of an allergic sensitization. Actually, local allergic rhinitis has been often misdiagnosed as well as mixed rhinitis has not been recognized in most cases. Nasal cytology is a diagnostic procedure being suitable for routine clinical practice with children and could be a very useful tool to characterize and diagnose non-allergic rhinitis, providing important clues for epidemiological analysis and clinical management.

Keywords: Pediatric chronic rhinitis, Non-allergic rhinitis, Nasal cytology, Local allergic rhinitis

Core tip: This manuscript aims at describing the current evidences regarding non-allergic rhinitis in children, whose diagnosis is probably underrated. Here, we described the epidemiology and the diagnostic definition of non-allergic rhinitis, highlighting also the differences compared to allergic rhinitis. Moreover, pathophysiological aspects, the emerging evidences on local allergic rhinitis and the growing role of nasal cytology in the diagnostic work-up of pediatric chronic rhinitis are discussed. Finally, insights on the therapeutic approach are provided.