Diagnosis and management of allergic rhinitis in pediatric patient: A case report

Background: Allergic rhinitis (AR) is a prevalent chronic condition affecting children and adults worldwide, with significant impacts on quality of life and daily functioning. Accurate diagnosis and effective management are essential to mitigate symptoms and improve outcomes.

Objective: To report a case of allergic rhinitis in pediatric patient.

Case Report: A 7-year-old female presented with a one-year history of left nasal obstruction, intermittent nasal bleeding, rhinorrhea, and sneezing exacerbated by dust exposure. History of allergy was present in family. Nasal endoscopy revealed mucosal erythema, congested turbinates, anterior septal deviation, and Grade IV adenoid enlargement. A skin prick test (SPT) identified sensitization to house dust (++++), bird feathers (++++), cat fur (+++), and specific foods. Normal eosinophil levels were noted. The patient was diagnosed with persistent moderate-to-severe allergic rhinitis and was treated with cetirizine, intranasal fluticasone furoate, and saline nasal irrigation, with significant symptom improvement at follow-up.

Clinical question: What is the optimal management approach for allergic rhinitis in pediatric patient?

Methods: A review of evidence-based literature on the management of allergic rhinitis in pediatric patient.

Result: Clinical history, physical examination, and SPT are important for diagnosing allergic rhinitis. Management guidelines recommend intranasal corticosteroids as first-line therapy for moderate-to-severe cases, supported by antihistamines and allergen avoidance.

Conclusion: This case underscores the importance of a tailored, evidence-based approach in managing pediatric allergic rhinitis. Accurate diagnosis, pharmacotherapy with cetirizine and fluticasone, adjunctive saline irrigation, and allergen avoidance led to rapid symptom resolution. These strategies align with ARIA guidelines and demonstrate the efficacy of multidisciplinary management in achieving optimal outcomes.