Published online Dec 26, 2016. doi: 10.5662/wjm.v6.i4.200
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
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.
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.