What causes allergic rhinitis?

In infancy and early childhood, the causes of allergic rhinitis are most often food allergens (cow's milk, formula, chicken eggs, semolina porridge, medications and reactions to vaccines), and in preschool and school age - inhalation allergens. What factors contribute to the development of allergic rhinitis? First of all, it is heredity.

Positive allergological anamnesis is found in parents with allergic rhinitis in 54% of cases, and with rhinosinusitis - in 16%. It is known that the development of respiratory allergies is facilitated by the anatomical features of the nasal cavity, prolonged contact with the allergen, increased permeability of the mucous membrane and vascular wall, developed cavernous tissue of the nasal conchae, that is, even normal anatomical and physiological situations. The situation worsens with pathological conditions in the nasal cavity, the most common example is the development of acute respiratory infections. This is also confirmed by statistical data: according to them, in 12% of cases, allergic rhinitis begins after an acute respiratory viral infection.

Risk factors for allergic rhinitis include the ecological environment in which the child lives. Most often, children have to come into contact with poultry and animals, fish and their food. Recently, brightly colored toys have appeared, and attention is also paid to fungal spores, down and feather pillows. It has been proven that the frequency of allergic rhinitis in a child in families where parents smoke (passive smoking) is 2-4 times higher. Very careful should be taken with newfangled chemicals, especially highly dispersed ones, for example, used to remove odor. It is known that the most important risk factor is house dust. A special place is occupied by the rapid reproduction of fungal spores in house dust with high humidity in the apartment in the autumn-winter period (up to 2500 in 1 g of dust). Allergic rhinitis may occur in a child after vaccination. Similar iatrogenic factors include lubrication and pouring drops into the nasal cavity, the introduction of a drug on a turunda. Fortunately, injections into the nasal septum and turbinates (procaine, steroids, antihistamines) are used less frequently in children than in adults. There are cases of allergic rhinitis after surgical interventions (adenotonsillectomy) performed during the flowering period of grasses. Even the birth of a child during the flowering period is a prerequisite for the development of allergic rhinitis. It has been proven that allergic rhinitis occurs 4 times more often in children born in May than in those born, for example, in February.

It can be concluded that the allergological anamnesis is collected quite thoroughly, however, this cannot be said about the pediatric anamnesis, especially about the information concerning the neonatal and infancy period. Meanwhile, risk factors include some somatic diseases of parents (mainly mothers), their professions (chemists, pharmacists, tasters associated with radiation and microwave irradiation, tobacco, furniture and textile production).

Local conditions that contribute to the development of allergic rhinitis:

• increased permeability of the nasal mucosa;
• anatomical features of the nasal cavity architecture, which determine long-term contact with allergens;
• features of venous circulation and a tendency to congestion due to the presence of cavernous tissue of the nasal concha;
• slight decrease in the motor activity of the ciliated epithelium, for example, with a change in pH;
• frequent respiratory diseases with damage to the nasopharynx;
• unfavorable conditions for drainage from the paranasal sinuses;
• difficulty breathing through the nose due to narrow nasal passages, aggravated by a deviated septum;
• adenoid vegetations;
• concomitant cervical regional lymphadenitis.

General conditions that contribute to the development of allergic rhinitis:

• time of birth of the child;
• neglect of risk factors in parental history: somatic diseases of the mother and the profession of the parents;
• vaccination;
• living in conditions of passive smoking, high humidity in the apartment, house dust (fungal spores);
• contact with pets, fish and birds (food):
• use of deodorants, modern toys with dangerous chemical ingredients;
• use of down pillows and blankets;
• frequent lubrication of the nasal cavity, administration of large quantities of medications, including vasoconstrictors, especially on turundas.
• intranasal injections, iontophoresis;
• performing surgical interventions during the flowering period.