מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – Sensitivity to mold allergens increases the risk of adenoid hypertrophy in children with allergic rhinitis, according to a report in the October issue of the Annals of Allergy, Asthma, and Immunology.

"Although the association with adenoid hypertrophy in patients with allergic rhinitis is casually cited in the literature," the authors explain, "to our knowledge, no study has been done so far to establish this relationship unequivocally."

Dr. Shih-Wen Huang and Dr. Carla Giannoni from the University of Florida in Gainesville, Florida compared the clinical parameters of 315 children with adenoid hypertrophy and allergic rhinitis with 315 control children referred for evaluation of allergic rhinitis and possible sinusitis. The children were divided into four groups by age: group I (1 to 3 years old), group II (4 to 6 years old), group III (7 to 12 years old), and group IV (12 to 18 years old).

Statistically significant clinical differences in the children with adenoid hypertrophy included higher rates of the following:
– otitis media in children younger than 6 years
– lower respiratory infection in children older than 3 years
– sinusitis in children between the ages of 4 and 12 years
– smoking exposure in children between 4 and 6 years
– sleep disorders in all groups
– antihistamine/decongestant usage in children 4 years and older

All age groups of children with adenoid hypertrophy had a higher prevalence of skin reactivity to molds, the researchers note, compared with children without adenoid hypertrophy. Relative risks ranged from 1.61 in group IV to 2.38 in group I.

Children with adenoid hypertrophy also showed a stronger reactivity in skin tests to more than three mold allergens, compared with controls, the investigators report.

There were no meaningful differences between patients and controls in skin reactivity to house dust mites, animal danders, or seasonal allergens, the report indicates.

"Sensitivity to mold allergens is an important risk factor for adenoid hypertrophy in children with allergic rhinitis," the authors conclude.

"Mold sensitivity is a serious problem in children who live in a humid and warm climate," Dr. Huang told Reuters Health. "The effort to avoid or diminish exposure of mold allergens should be applied to all patients with allergic rhinitis."

Dr. Huang offered some pointers for reducing the risk of adenoid hypertrophy. First, avoid air-conditioning in cars left under the hot sun or in hot weather. This may be a source of mold exposure.

Second, "don't let children lie on carpets while they are watching TV or playing games in the house. The reservoirs of molds are found in the space between the carpet and the cement floor underneath it," he said.

Third, "any way to reduce humidity in the house will help decrease mold growth."

Lastly, he cautions against any smoking in the home, "especially with children who already have respiratory problems."