Allergy testing in children: why, who, when and how?

Høst, Arne; Andrae, S; Чаркин, С. А.; Díaz-Vázquez, Carlos A.; Dreborg, Sten; Eigenmann, Philippe; Friedrichs, Frank; Grinsted, Per; Lack, Gideon; Meylan, G.; Miglioranzi, P; Muraro, Antonella; Nieto, Antonio; Niggemann, B.; Pascual, Carlos; Pouech, M.-G.; Rancé, F.; Rietschel, Ernst; Wickman, Magnus

doi:10.1034/j.1398-9995.2003.00238.x

Cited by 176 publications

(129 citation statements)

References 105 publications

(114 reference statements)

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“…However, this 5-year watershed may be a deterrent to the prescription of SLIT at the very age when the allergic march starts and when the early diagnosis of atopy should be made. 26,27 Furthermore, a preventive effect of specific immunotherapy on the natural history of allergic disease may be lost with later onset of therapy. 28,29 We did not set out to evaluate the safety of SLIT in young children, but evaluated young Italian children who received SLIT as part of the management of their asthma or rhinoconjunctivitis irrespective of the reason why SLIT had been prescribed.…”

Section: Discussionmentioning

confidence: 99%

Safety of sublingual-swallow immunotherapy in children aged 3 to 7 years

Fiocchi¹,

Pajno

Grutta³

et al. 2005

Annals of Allergy, Asthma & Immunology

112

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Background:The minimum age to start specific immunotherapy with inhalant allergens in children has not been clearly established, and position papers discourage its use in children younger than 5 years.Objective: To assess the safety of high-dose sublingual-swallow immunotherapy (SLIT) in a group of children younger than 5 years.Methods: Sixty-five children (51 boys and 14 girls; age range, 38 -80 months; mean Ϯ SD age, 60 Ϯ 10 years; median age, 60 months) were included in this observational study. They were treated with SLIT with a build-up phase of 11 days, culminating in a top dose of 300 IR (index of reactivity) and a maintenance phase of 300 IR 3 times a week. The allergens used were house dust mites in 42 patients, grass pollen in 11 patients, olive pollen in 5 patients, Parietaria pollen in 4 patients, and cypress pollen in 3 patients. All adverse reactions and changes in the treatment schedule were compared in 2 subgroups: children 38 to 60 months old and children 61 to 80 months old.Results: The average cumulative dose of SLIT was 36,900 IR. Adverse reactions were observed in 11 children, none of them severe enough to require discontinuation of immunotherapy. Six reactions occurred in the 60 months or younger age group and 7 in the older than 60 months age group, with no differences between these 2 groups.Conclusion: High-dose immunotherapy in children younger than 5 years does not cause more adverse reactions than in children aged 5 to 7 years. There is no reason to forbear studies on safety and efficacy of these preparations in young children.Ann Allergy Asthma Immunol. 2005;95:254-258.

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Section: Discussionmentioning

confidence: 99%

Safety of sublingual-swallow immunotherapy in children aged 3 to 7 years

Fiocchi¹,

Pajno

Grutta³

et al. 2005

Annals of Allergy, Asthma & Immunology

112

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“…Nevertheless, in each individual case presenting with symptoms resembling allergy, the presence or absence of allergy can be difficult to determine without an IgE antibody test [1]. However, it is essential to emphasise that the test results need to be interpreted in the context of the clinical presentation [3,[13][14][15].…”

Section: Ige Antibody-mediated Allergic Diseasementioning

confidence: 99%

In vitro diagnosis of allergy: how to interpret IgE antibody results in clinical practice

Ahlstedt

Murray

2006

Primary Care Respiratory Journal

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SummaryThe basis of any diagnosis of allergy requires a good history and examination, which should then provide a certain degree of confidence as to whether or not allergy is present. However, the diagnosis cannot be confirmed on the basis of symptoms alone, because both allergic and non-allergic conditions can present with similar symptoms. Based on prevalence figures, about half of the patients presenting with allergic symptoms in primary care may be non-allergic. Therefore, allergy testing in the form of specific IgE (sIgE) measurement and/or skin prick testing is an invaluable aid in demonstrating both the presence and severity of such an allergy. The usefulness of such tests extends beyond just the positive or negative result. Often, more information can be gleaned by using the test results in a form of a continuous variable in order to determine the likelihood that allergy can be attributed as an explanation for patients' symptoms and disease. In this review, we describe the rationale for utilising specific IgE antibody tests in diagnosing allergy. Furthermore, to optimize the information gained from allergy testing, we describe how to employ one particular well-validated IgE testing system for determining the likelihood that an individual patient's disease can be attributed to allergy.

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“…Sensitization to allergens has been shown to be strongly associated with the development of atopic diseases (2,3). Therefore, the assessment of allergen sensitization is considered to be necessary in diagnosing and managing atopic diseases in childhood (4).…”

Section: Introductionmentioning

confidence: 99%

Allergen Sensitization Patterns in Atopic Children in Mersin Province of Turkey

Arıkoğlu¹,

Batmaz²,

Kuyucu³

2017

Asthma Allergy Immunol

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ÖZAmaç: Allerjen duyarlılığının spektrumu, ülkeler arasında ve aynı ülke içindeki bölgeler arasında büyük farklılıklar gösterir. Çalışmamızın amacı allerji kliniğimize başvuran atopik çocuklarda allerjen duyarlılığının dağılımını araştırmaktır. Gereç ve Yöntem:Ocak 2014 ile Ocak 2017 arasında allerjik hastalık şüphesiyle kliniğimize başvuran ve en az bir allerjen duyarlılığı olan çocuklar retrospektif olarak değerlendirildi. Klinik tanıları ve total IgE, serum eozinofil sayıları, deri prik testi (DPT), besin ve inhalan spesifik IgE sonuçları gibi atopi belirteçleri değerlendirildi. Bulgular: Çalışmada 1307 hasta değerlendirildi. Hastaların ortalama yaş 9.0±4.4 yıl ve %61.9'u erkekti. Allerjik rinit en sık saptanan tanı %38.9 olup, bunu astım (%32.9), ürtiker (%15.9) ve atopik dermatit (%5.4) izledi. Besin spesifik IgE (fx5) pozitifliği hastaların %27.6'sında mevcuttu. Besin allerjenleriyle DPT pozitifliği oranı %8.3 idi. DPT' de en sık saptanan besin allerjenleri yumurta (%4.4), inek sütü (%2.3) ve yer fıstığı (%1.7) idi. Hastaların %83'ünde inhalan spesifik IgE (phadiatop) pozitifliği mevcuttu. DPT' deki en sık saptanan aeroallerjenler Dermatophagoides pteronyssinus (%67.9), Dermatophagoides farinae (%67.2), Alternaria alternata (%19.4) ve çayır poleni (% 17.7) idi. Polisensitizasyon hastaların %39.5'inde saptandı. 187 (%14.3) hastada phadiatop negatifti ancak inhalanlarla DPT pozitifliği mevcuttu. Bu hastalar arasında, DPT' de en sık saptanan allerjenler akarlar (%20.8), Alternaria alternata (%20.3) ve hamamböceği (%11.8) idi. Alternaria monosensitizasyonu olanlar arasında ise phadiatop testi %50.8 oranında negatifti. ABSTRACTObjective: The spectrum of allergen sensitization differs widely between countries and also regions within the same country. The aim of this study was to investigate the allergen sensitization patterns of atopic children who presented to our allergy clinic. Materials and Methods:The study retrospectively reviewed all children who presented to our clinic with a suspicion of allergic diseases and had at least one allergen sensitization between January 2014 and January 2017. Clinical diagnosis and atopy markers such as total IgE, serum eosinophil counts, skin prick test (SPT), food and inhalant specific IgE results were evaluated.Results: A total of 1307 patients were evaluated. The mean age of the children was 9.0±4.4 years and 61.9% were male. Allergic rhinitis was the most common diagnosis with a frequency of 38.9%, followed by asthma (32.9%), urticaria (15.9%) and atopic dermatitis (5.4%). Food mix specific IgE (fx5) positivity was present in 27.6% of patients. The rate of SPT positivity for food allergens was 8.3%. Eggs (4.4%), cow's milk (2.3%) and peanut (1.7%) were found to be the most common food allergens in SPT. Inhalant specific IgE (phadiatop) positivity was present in 83.0% of the patients. The most common aeroallergens in SPT were Dermatophagoides pteronyssinus (67.9%), Dermatophagoides farinae (67.2%), Alternaria alternata (19.4%) and grass mix (17.7%). Polysensitization was ...

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Allergy testing in children: why, who, when and how?

Cited by 176 publications

References 105 publications

Safety of sublingual-swallow immunotherapy in children aged 3 to 7 years

Safety of sublingual-swallow immunotherapy in children aged 3 to 7 years

In vitro diagnosis of allergy: how to interpret IgE antibody results in clinical practice

Allergen Sensitization Patterns in Atopic Children in Mersin Province of Turkey

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