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This study investigates how allergic rhinitis severity relates to adenoid hypertrophy in children sensitized to dust mites.

May 18, 2026Journal of Asthma and Allergy0 citationsOpen Access

Severity-Dependent Association Between Allergic Rhinitis and Adenoid Hypertrophy in Dust Mite–Sensitized Children from Northern China: A Cross-Sectional Analysis of 170 Cases

BZBo ZhaoSecond Hospital of Shandong University YWYuxing WangSouth China Agricultural University HZHongyang ZhangQingdao University of Science and Technology

Key Points

This study investigates how allergic rhinitis severity relates to adenoid hypertrophy in children sensitized to dust mites.
Conducted a cross-sectional analysis of 170 dust mite-sensitized children from Northern China.
Assessed adenoid hypertrophy using nasal endoscopy, classifying it as grade III or IV.
Evaluated allergic rhinitis severity through TNSS, VAS, and PRQLQ-S scores, along with allergic inflammatory markers.
Children with grade IV adenoid hypertrophy had significantly higher TNSS and VAS scores than those with grade III (P < 0.001).
Moderate positive correlations were found between nasal obstruction scores and TNSS (r = 0.426), VAS (r = 0.458), and PRQLQ-S (r = 0.348) (all P < 0.001).
Eosinophil counts, total IgE, and dust mite-specific IgE showed significant but weaker correlations with adenoid obstruction.

Abstract

Background: Allergic rhinitis (AR) and adenoid hypertrophy (AH) frequently coexist in children, yet the relationship between allergic disease severity and the extent of adenoid enlargement remains incompletely defined. This study aimed to investigate the association between AR severity, allergic inflammatory burden, and the degree of AH in dust mite–sensitized children. Methods: We conducted a cross-sectional analysis of 170 children with dust mite–sensitized AR from Northern China. AH was assessed by nasal endoscopy and classified as grade III or IV. AR severity was evaluated using the Total Nasal Symptom Score (TNSS), visual analogue scale (VAS), and Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ-S). Allergic inflammatory markers included peripheral blood eosinophil counts (EOS), total IgE, and Dermatophagoides pteronyssinus (d1) and Dermatophagoides farinae (d2)-specific IgE. Group comparisons and Spearman correlation analyses were performed. Results: Children with grade IV AH exhibited significantly higher TNSS, VAS scores, and nasal symptom burden compared with those with grade III hypertrophy (all P < 0.001). Nasal obstruction, rhinorrhea, and nasal itching scores were also significantly increased. TNSS (r = 0.426), VAS (r = 0.458), and PRQLQ-S (r = 0.348) showed moderate positive correlations with the percentage of choanal obstruction (all P < 0.001). In addition, eosinophil counts, total IgE, and dust mite–specific IgE levels demonstrated weaker but significant correlations with adenoid obstruction. Conclusion: AR severity is positively and dose-dependently associated with AH in dust mite–sensitized children. These findings suggest that adenoid enlargement is associated with clinical and immunological markers of allergic inflammation and highlight the importance of early and effective control of allergic rhinitis to prevent progressive AH. Keywords: allergic rhinitis, AH, allergen, dust mite-sensitized, allergy

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