Recurrent Anterior Epistaxis in Children With Allergic Rhinitis and Non-Allergic Rhinitis: Clinical Features.

Abstract

Objective: This study described the endoscopic characteristics of recurrent anterior epistaxis (RAE) with and without allergic rhinitis (AR), and the outcomes of treatment with mupirocin ointment.

Material and methods: Children with RAE were examined using nasal endoscopy, serum specific immunoglobulin E antibodies, and skin-prick test. The children were divided into AR (RAE with AR) and non-AR (RAE without AR) groups. All children received mupirocin ointment topically twice daily for 4 weeks. Recurrent epistaxis and epistaxis severity scores were compared at 2, 4, and 12 weeks of follow-up.

Results: A total of 326 patients with 432 nostrils with RAE were included; 76.4% of patients had the bad habit of frequent nose-picking or rubbing. Of the 178 nostrils in the AR group, diffuse telangiectasia was found in 89.3%, scattered telangiectasia in 8.4%, and mucosal ulceration in 2.3%. Of the 254 nostrils in the non-AR group, the endoscopic findings of the anterior septum in the bleeding nostrils included mucosal ulceration in 77.6%, scattered telangiectasia in 17.7%, isolated punctate telangiectasias in 3.1%, and diffuse telangiectasia in 1.6%. In addition, the prevalence of mucosal crusts in the non-AR group was significantly higher than in the AR group (76.8% vs 20.8%), whereas the prevalence of severe hypertrophic inferior turbinates or nasal secretion was significantly higher in the AR group. The prevalence of recurrent epistaxis was significantly higher in the AR group than in the non-AR group at 2 (71.3% vs 57.7%), 4 (65.7% vs 37.8%), and 12 (78.1% vs 43.5%) weeks post-treatment.

Conclusions: AR was common in children with RAE, with prominent diffuse telangiectasia evident by endoscopy in most, while most non-AR RAE children had mucosal ulceration or scattered telangiectasia. Compared with outcomes in non-AR RAE children, the efficacy of mupirocin ointment in the treatment of RAE with AR was not satisfactory.