Allergic rhinitis and recurrent epistaxis in children.

BACKGROUND

Many allergists, but few otolaryngologists, consider allergic rhinitis to be a common cause of nosebleeds in childhood.

OBJECTIVE

To determine whether the two conditions are related, and whether epistaxis could be due solely to the local effects of nasal symptoms.

METHODS

We studied 557 children who were referred consecutively to an allergy clinic of a children's hospital. Standardized questions were put to their accompanying parents, and skin prick tests were performed on the children, using common local inhalant allergens.

RESULTS

On univariate analysis children who had both nasal symptoms and a positive skin 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 regression the odds ratio (OR) of nosebleeds was 3.3, 1.3, 1.65, and 1, respectively. 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 commonly associated with recurrent epistaxis. In many children it appears that nosebleeds are due to nasal symptoms plus some abnormality that is found in the atopic state: a disorder of hemostasis is suspected as the contributing factor.