{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T19:02:39Z","timestamp":1775070159256,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T00:00:00Z","timestamp":1616976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["CM20\/00160"],"award-info":[{"award-number":["CM20\/00160"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["JR19\/00029"],"award-info":[{"award-number":["JR19\/00029"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["JR18\/00054"],"award-info":[{"award-number":["JR18\/00054"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI17\/01410"],"award-info":[{"award-number":["PI17\/01410"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI20\/01715"],"award-info":[{"award-number":["PI20\/01715"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["RD16\/0006\/0001"],"award-info":[{"award-number":["RD16\/0006\/0001"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Three allergic phenotypes of rhinitis have been described in adults: allergic rhinitis (AR), local allergic rhinitis (LAR), and dual allergic rhinitis (DAR, coexistence of AR and LAR). Nevertheless, most centers follow a diagnostic approach only based on skin prick test and serum allergen\u2013specific IgE (collectively called atopy tests, AT). This approach prevents the recognition of LAR and DAR, the diagnosis of which requires a nasal allergen challenge (NAC). Here, we investigate the existence of LAR and DAR phenotypes in children and adolescents, and the misdiagnosis rate associated with a work\u2010up exclusively based on AT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical data were obtained during physician\u2010conducted interviews, and AT and NAC were systematically performed in 5\u2010 to 18\u2010year\u2010old patients with chronic rhinitis. The misdiagnosis rate was defined as the proportion of cases where AT and NAC results were discordant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 173 patients (mean age 15.1\u00a0years, 39.9% male) completed the study. AR (positive AT and NAC), LAR (negative AT and positive NAC), DAR (positive AT and NAC for some allergens and negative AT and positive NAC for other allergens), and non\u2010allergic rhinitis (negative NAC) were diagnosed in 45.7%, 24.9%, 11.6%, and 17.9% of individuals, respectively. The clinical profile was comparable among allergic phenotypes, but allergic patients had a significantly earlier rhinitis onset, higher conjunctivitis prevalence, and more severe disease than NAR individuals. A diagnostic work\u2010up exclusively based on AT misclassified 37.6% of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LAR and DAR represent relevant differential diagnosis in pediatric rhinitis. NAC increases the diagnostic accuracy of clinical algorithms for rhinitis in children and adolescents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pai.13474","type":"journal-article","created":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T04:19:31Z","timestamp":1613621971000},"page":"953-962","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Systematic evaluation of allergic phenotypes of rhinitis in children and adolescents"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0683-8766","authenticated-orcid":false,"given":"Ana","family":"Prieto","sequence":"first","affiliation":[{"name":"Pediatrics Unit Hospital Regional Universitario de Malaga Malaga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Rond\u00f3n","sequence":"additional","affiliation":[{"name":"Allergy Unit Hospital Regional Universitario de Malaga Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2010IBIMA and ARADyAL Malaga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3774-931X","authenticated-orcid":false,"given":"Ibon","family":"Eguiluz\u2010Gracia","sequence":"additional","affiliation":[{"name":"Allergy Unit Hospital Regional Universitario de Malaga Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2010IBIMA and ARADyAL Malaga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Candelaria","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Pediatrics Unit Hospital Regional Universitario de Malaga Malaga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Almudena","family":"Testera\u2010Montes","sequence":"additional","affiliation":[{"name":"Allergy Unit Hospital Regional Universitario de Malaga Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2010IBIMA and ARADyAL Malaga Spain"},{"name":"Department of Medicine and Dermatology Universidad de Malaga Malaga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gador","family":"Bogas","sequence":"additional","affiliation":[{"name":"Allergy Unit Hospital Regional Universitario de Malaga Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2010IBIMA and ARADyAL Malaga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esmeralda","family":"Nu\u00f1ez Cuadros","sequence":"additional","affiliation":[{"name":"Pediatrics Unit Hospital Regional Universitario de Malaga Malaga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paloma","family":"Campo","sequence":"additional","affiliation":[{"name":"Allergy Unit Hospital Regional Universitario de Malaga Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2010IBIMA and ARADyAL Malaga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria J.","family":"Torres","sequence":"additional","affiliation":[{"name":"Allergy Unit Hospital Regional Universitario de Malaga Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2010IBIMA and ARADyAL Malaga Spain"},{"name":"Department of Medicine and Dermatology Universidad de Malaga Malaga Spain"},{"name":"Laboratory for Nanostructures for the Diagnosis and Treatment of Allergic Diseases Andalusian Center for Nanomedicine and Biotechnology (BIONAND) Malaga 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