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Wise et al.

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identified with AH assessed for allergy sensitization. These may not represent the same populations.

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Three studies assessing allergic children found a higher rate of AH than controls (when present). In 2015, 1322 children (mean age 5.9 ± 3.3 years) treated for “allergic conditions” were compared to 100 age-matched children with no allergic disease for AH. They found AH was more prevalent in the allergic group (12.4%) than controls (3%) ( p < 0.0001). AH was statistically associated with AR and cigarette smoke exposure ( p = 0.004). 1933 Similarly, Dogru et al. 1934 found that among 566 children with AR the prevalence of AH was 21.2% (no control group). Additionally, they reported that children with both AH and AR had a higher frequency of persistent rhinitis ( p < 0.05), moderate/severe rhinitis ( p = 0.005), and nasal congestion ( p = 0.001) than those with AR alone. The AR-only group had a higher prevalence of asthma ( p = 0.037) and “itchy nose” (0.017). In another study, adenoid size in seasonally allergic children was assessed by Modrynski and Zawisza, 1935 concluding that seasonal adenoid enlargement was observed in birch pollen–allergic children more than controls not allergic during the tree-pollen season. The increased adenoid size resolved after pollen season in the study group, and the seasonal increase in adenoid size was not observed in birch-allergic children treated co-seasonally with topical nasal steroid and antihistamines. The study was small (n = 67 among 4 groups) and did not state whether it was blinded (Table X.F). Exposure and sensitization to mold and AH has been specifically examined. Atan Sahin et al. 1936 compared 242 children living in a less humid environment to 142 children living on the more humid Turkish Mediterranean coast. Mite-sensitive children in the coastal group had an increase in AH ( p = 0.01). Those living in the more humid coastal location demonstrated increased mold and pollen sensitization but no significant correlation with adenoid hypertrophy was found. In contrast, Huang and Giannoni 1937 compared 315 children with AH and AR to age-matched controls with AR-alone. There was a higher prevalence of positive skin tests to molds in the AH group ( p = 0.013 to <0.0001). Dogru et al. 1934 also reported an increased sensitization to Alternaria in children with both AH and AR compared to AR alone ( p = 0.032), although a statistical correction for multiple variables was not described. In studies where children were recruited by nasal obstruction, the degree of AH sometimes showed either no relationship or an inverse relationship with the prevalence of allergy sensitization. Cassano et al. 1931 reported that the prevalence of specific inhalant IgE sensitization decreased as the AH increased: AH first degree (37% sensitized), AH second degree (35% sensitized), and AH third degree (19% sensitized). Karaca et al. 1938 did SPT on 82 children who presented with upper airway obstruction to an otolaryngology clinic and compared allergy sensitization to radiographic adenoid size and clinically assessed tonsil size. They concluded that there was not a statistically significant association with adenoid size ( p = 0.195) and a negative correlation with tonsil size ( p = 0.045). The methods are vague on how the correlation was performed with tables showing percentages of “negative” SPT and the text incongruently stating “all of the cases were positive for at least 1 of the 14 allergens.” 1938 Ameli et al. 1939 assessed 205 children (mean age 6.7 years) with nasal endoscopy and SPT and found an association between negative SPT and adenoid volume ( p

Int Forum Allergy Rhinol . Author manuscript; available in PMC 2020 June 10.