Is rhinitis a risk factor for severe asthma in children?

OBJECTIVE: To evaluate the role of rhinitis on asthma severity among active asthmatic (AA) schoolchildren identified by the International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire (WQ).METHODS: WQ was applied to parents of 6-7 years-old schoolchildren (SC, n=3,033), and to adolescents (AD,(13)(14) n=3,487), living in Silo Paulo, Brazil.An affirmative response to "Has your child/have you had wheezing/whistling in the last year?"identified those with AA, and an affirmative response to "...the last 12 months has your child/have you had sneezing/runny/blocked nose when he/she/you did not have a cold/flu?"identified those with rhinitis (R).Subjects who had R associated with AA were identified as AA+R.RESULTS: 22.1% AD and 24.3% SC were identified as AA.56.9% of those AD and 54.6% SC had AA+R.Considering AA and AA+R groups, speech disturbance during an acute episode of asthma was significantly higher among AA+R AD (14.1% vs 8.7% p=0.03) and AA+R SC (15.8% vs 10.5% p=0.0435) in comparison to AA.Likewise, more than 4 acute attacks in the last year was significantly higher among AA+R AD ( 15.7% vs 10.5% p=0.046) and AA+R SC (22.6% vs 12.8% p=0.0009) as the frequency of sleep disturbance due to wheezing, for AD (18.5% vs 12.3% p=0.027) and SC (70.0%vs 58.1% p=0.0012), and for "wheezing associated to exercise" for AD (51.7% vs 40.0%p=0.0015) and SC (32.7% vs 14.1% p<0.0001).CONCLUSIONS: In patients with AA+R, the presence of R is a risk factor for asthma severity.