ALLERGIC RHINITIS AND RECURRENT EPISTAXIS IN CHILDREN

Background:-Many allergists, but few otolaryngologists, consider aller gic rhinitis to be a common cause of nosebleeds in childhood. Objectiv e:-To determine whether the two conditions are related, and whether ep istaxis could be due solely to the local effects of nasal symptoms. Me thods:-We studied 557 children who were referred consecutively to an a llergy clinic of a children's hospital. Standardized questions were pu t to their accompanying parents, and skin prick tests were performed o n the children, using common local inhalant allergens. Results:-On uni variate analysis children who had both nasal symptoms and a positive s kin test were found to have recurrent nosebleeds more frequently (20.2 %) than had those with nasal symptoms on their own (9.9%), a positive skin test alone (3.4%), or neither (2.1%). Similarly, on logistic regr ession the odds ratio (OR) of nosebleeds was 3.3, 1.3, 1.65, and 1, re spectively. Nosebleeds were more common in those who owned a dog or a cat and had a positive skin test to that species than in the remainder of the children (27.8% vs 10.8%). Conclusions:-Allergic rhinitis is c ommonly associated with recurrent epistaxis. In many children it appea rs that nosebleeds are due to nasal symptoms plus some abnormality tha t is found in the atopic state: a disorder of hemostasis is suspected as the contributing factor.