Vázquez Daniel, Onetti Cora Isabel, Parisi Claudio Alberto, Martínez Jorge César, Croce Juan, Moreno Pablo, García Marcela, Ivancevich Juan Carlos, Gómez R Maximiliano
Asociación Argentina de Alergia e Inmunología Clínica, Buenos Aires, Argentina.
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Rev Alerg Mex. 2020;67 Suppl 1:S1-S28. doi: 10.29262/ram.v67i0.649.
Allergic rhinitis (AR) is the most frequent allergic disease. Prevalence in children and teenagers in Argentina ranges between 22.3% and 34.9%. Given this situation, members of the scientific committees of Pediatrics and Rhinitis of the Argentinian Association of Allergy and Clinical Immunology (AAAeIC) have reviewed scientific evidence in order to update the therapeutic regulations of this pathology in the pediatric population. The classification and categorization of AR are currently in full review all around the world. It is necessary to make a differential diagnosis with other non-allergic types of rhinitis in children, and to confirm AR based on the clinical history, physical examination, determination of bio-markers, and/or skin tests. Non-pharmacological treatment includes education and guidelines of environmental control for allergens such as dust mites, anemophilous fungi, animal epithelium, and pollens. Step pharmacological therapy is proposed according to the control of the disease. Second-generation, non-sedating anti-histamines are the first line of therapy. The association with oral decongestants is not recommended in children under 4 years of age. Inhaled corticosteroids are the first choice for both moderate and severe forms. This document warns pediatricians about the importance of an early diagnosis, the rational use of step pharmacological therapy, and specific immunotherapy in children.
变应性鼻炎(AR)是最常见的过敏性疾病。阿根廷儿童和青少年中的患病率在22.3%至34.9%之间。鉴于这种情况,阿根廷过敏与临床免疫学会(AAAeIC)的儿科学和鼻炎科学委员会成员审查了科学证据,以便更新儿科人群中这种疾病的治疗规范。目前,AR的分类和分级在全球范围内正在全面审查。有必要与儿童其他非过敏性鼻炎类型进行鉴别诊断,并根据临床病史、体格检查、生物标志物测定和/或皮肤试验来确诊AR。非药物治疗包括针对尘螨、风媒真菌、动物上皮和花粉等过敏原的环境控制教育和指导原则。根据疾病控制情况提出阶梯式药物治疗。第二代非镇静抗组胺药是一线治疗药物。4岁以下儿童不建议联合使用口服减充血剂。吸入性糖皮质激素是中度和重度病例的首选药物。本文档提醒儿科医生注意儿童早期诊断、合理使用阶梯式药物治疗以及特异性免疫治疗的重要性。