Corticosteroids in the treatment of pediatric allergic rhinitis

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Presentation transcript:

Corticosteroids in the treatment of pediatric allergic rhinitis Glenis K. Scadding, MD Journal of Allergy and Clinical Immunology Volume 108, Issue 1, Pages S59-S64 (July 2001) DOI: 10.1067/mai.2001.115568 Copyright © 2001 Mosby, Inc. Terms and Conditions

Fig. 1 Effects of topical corticosteroids on nasal mucosa. Topical corticosteroids act at multiple sites; their major actions are on antigen presenting cells, T-cells, and eosinophils, but they also reduce mast cell numbers in epithelium. In addition, vascular permeability and mucus production are decreased. Journal of Allergy and Clinical Immunology 2001 108, S59-S64DOI: (10.1067/mai.2001.115568) Copyright © 2001 Mosby, Inc. Terms and Conditions

Fig. 2 Steroid loading. Many children with rhinitis also have other atopic conditions, all of which may be treated with various topical formulations of corticosteroids. Total steroid burden should always be considered, and clinicians must take into consideration total risk of systemic side effects when corticosteroids are indicated in treatment of multiplicity of atopic conditions. This can be difficult if the child is attending several different clinics. Journal of Allergy and Clinical Immunology 2001 108, S59-S64DOI: (10.1067/mai.2001.115568) Copyright © 2001 Mosby, Inc. Terms and Conditions

Fig. 3 Effects of intranasal corticosteroids vs placebo on adrenal markers of systemic activity. (Adapted from Wilson AM, Sims EJ, McFarlane LC, Lipworth BJ. Effects of intranasal corticosteroids on adrenal, bone, and blood markers of systemic activity in allergic rhinitis. J Allergy Clin Immunol 1998;102:598-604.) Journal of Allergy and Clinical Immunology 2001 108, S59-S64DOI: (10.1067/mai.2001.115568) Copyright © 2001 Mosby, Inc. Terms and Conditions