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

Bo Zhao,1 Yang Wang,2 Hongyang Zhang,2 Peng Jin,2 Tao Jia2 1Center of Stomatology, The Second Qilu Hospital of Shandong University, Jinan, Shandong, People’s Republic of China; 2Department of Otolaryngology, The Second Qilu Hospital of Shandong University, Jinan, People’s Republic of ChinaCorrespondence: Tao Jia, Department of Otolaryngology, The Second Qilu Hospital of Shandong University, 247 Beiyuan Avenue, Jinan, Shandong, 250033, People’s Republic of China, Email [email protected]: 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