The etiology of CSU in children was mostly idiopathic despite detailed investigation. In childhood, the natural course of CSU was favorable, and nearly half of the patients recovered after 5 years of disease duration. A high UAS7 at admission seemed to be a significant risk factor for the persistence of symptoms.
Emergence of new environmental risk factors, and/or loss of protective factors of a traditional lifestyle may explain the increase, or variations in prevalence of allergic diseases. The aim of this study was to delineate the prevalence and spectrum of, and to reveal the causal and/or protective factors for atopic sensitization among a heterogeneous cohort of Turkish children, for the first time in our country. The study design adhered to International Study of Asthma and Allergies in Childhood (ISAAC) phase II protocol. A self-administered parental questionnaire about demographic characteristics and detailed risk factors, and skin-prick test with 13 allergens were employed in a clustered random sample of 8-11-yr-old Turkish school children. Atopy was defined as the presence of at least one positive skin reaction to any allergen tested. The association between a total of 78 risk factors and different aspects of atopy were analyzed in 1144 children with multivariate logistic regression analysis. The overall prevalence of atopy was 20.6%. Most common sensitizations were to grass pollens, Dermatophagoides pteronyssinus and Blatella germanica. Day care attendance, high paternal education level, male gender and maternal asthma were significant risk factors for atopy. Breastfeeding more than 6 months (compared with 0-6 months), maternal smoking during pregnancy and a birth weight under 2500 g were inversely related to (or protective factors for) atopic sensitization. Maternal atopic disease had significant effects on risk factors pattern. In children with a maternal atopy history a low birth weight, day care attendance and maternal smoking during the first year of life independently increased the risk of atopic sensitization. Gender, breastfeeding and paternal education did not show any association with atopy in this group of children. A history of measles and low gestational age were significant protective factors for mite sensitization. This study showed that children of atopic mothers showed a different profile of risk factors associated with atopic sensitization, when compared with other children. Prenatal and early childhood events had important associations with atopic sensitization.
Background/Objective: The skin prick test (SPT) is the standard tool for the diagnosis of IgE-mediated allergic diseases. The number and spectrum of allergen extracts to be applied for the diagnosis of sensitized patients in order to achieve the most cost-effective and informative results are critical from both economic and scientific viewpoints. Methods: In order to determine the minimum test battery panel necessary to cover at least 95% of the cases of SPT sensitization in children and adolescents (2–18 years) with suspected respiratory allergies, we retrospectively analyzed the SPT results of the largest referral center of the country. Results: Over a 2.5-year period, a total of 2,457 children (male/female ratio 1.51) with a median (range) age of 6.8 years (2.0–18.0) were subjected to SPT. Eight hundred and sixty-two (35.1%) children were found to be sensitized to at least one of the 30 aeroallergen extracts tested. The most common sensitizations were to grasses (Festuca pratensis, Phleum pratense, Dactylis glomerata, and Lolium perenne), house dust mites (Dermatophagoides pteronyssinus and Dermatophagoides farinae), cat, weeds (Chenopodium, Plantago, and Artemisia), and moulds (Alternaria and Cladosporium). The sensitization rates increased in conjunction with an increase in age. Testing with 12, 8, and 7 allergens was sufficient to identify over 95% of the sensitized preschool children, school children, and adolescents, respectively. Conclusion: An SPT panel covering 12 allergen extracts was sufficient to detect most of the sensitized children and adolescents with recurrent respiratory symptoms. As the patients grow older, a smaller test panel is required compared to the panels used at younger ages.
While parental reported food allergy prevalence was within the range reported previously, confirmed IgE-mediated food allergy prevalence among adolescents was at least 0.16%, and the spectrum of foods involved in allergy differed from Western countries, implying environmental factors may play a role.
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