A B Murray1, R A Milner. 1. University of British Columbia, B.C.'s Children's Hospital, Vancouver, Canada.
Abstract
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.
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.