What is involved in the diagnosis of pediatric allergic rhinitis?

Updated: Jun 04, 2021
  • Author: Jack M Becker, MD; Chief Editor: Harumi Jyonouchi, MD  more...
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Perform a full examination to detect other diseases, such as adenoidal hypertrophy, asthma, eczema, and cystic fibrosis, which occur in children in connection with allergic rhinitis. Evaluation of the child involves the head, eyes, ears, nose, and throat, and can include the following:

  • Head: Allergic shiners (dark, puffy, lower eyelids), Morgan-Dennie lines (lines under the lower eyelid), transverse crease at lower third of nose secondary to nose rubbing as in the allergic salute

  • Eyes: Marked erythema of palpebral conjunctivae and papillary hypertrophy of tarsal conjunctivae; chemosis of the conjunctivae, usually with a watery discharge; in severe cases, cataracts from severe rubbing secondary to itching

  • Ears: Chronic infection or middle ear effusion

  • Nose: Enlarged turbinates with pale-bluish mucosa due to edema; clear or white nasal discharge (rarely yellow or green); dried blood secondary to trauma from nose rubbing; rarely, polyps (if polyps detected on rhinoscopy, mandatory workup for cystic fibrosis in children)

  • Throat: Discoloration of frontal incisors, high arched palate, and malocclusion associated with chronic mouth breathing; cobblestoning in the posterior pharynx secondary to chronic nasal congestion and postnasal drainage

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