Development of Respiratory Allergies, Asthma and Allergic Rhinits in Children with Atopic Dermatitis

Abstract

SUMMARY -Children with atopic dermatitis (AD) usually develop symptoms when they reach the age of 6-7 years, but the risk of developing respiratory allergies, asthma and allergic rhinitis (AR) remains high. In most children with AD, the development of asthma and AR is associated with sensitization to food allergens and/or aeroallergens, while only a small percentage missed atopic diathesis. In about 35% of children with AD, food allergy is the provoking cause, and 60% of infants who had AD in the fi rst 3 months of life were sensitized against aeroallergens by the age of 5. Th e aim of the study was to follow development of asthma and AR and to assess the most signifi cant risk factors for developing respiratory allergy. A total of 114 children with AD were followed up for fi ve years. At annual visits, the severity of disease, total immunoglobulin E (IgE) antibody values, skin prick tests, specifi c IgE antibodies to food allergens and aeroallergens, and absolute eosinophil count were assessed. Information on the family history of atopy and AD, feeding patterns during infancy, data on sensitivity to food allergens and/or aeroallergens, and on the occurrence of bronchial obstruction and nose symptoms were obtained. Asthma developed in 36 children, median age 7.7 years; 33 children had symptoms of AR, and 13 children with AD had both diseases associated; 38 children had sensitivity to food, of which 24 developed asthma and 13 AR; asthma developed in 18/23 children with sensitivity to aeroallergens, and almost an equal number of children developed AR. Th e increased absolute eosinophil count and specifi c IgE to aeroallergens and food allergens were the best asthma predictors, while AR predictors were family history and early onset of AD. In conclusion, children with AD are at a signifi cant risk of developing respiratory allergies, and those with the increased absolute eosinophil count, positive specifi c IgE to aeroallergens and food allergens, heredity of AD, and early onset of AD are at the highest risk. Identifi cation of risk factors will enable us to improve the treatments of AD in order to reduce the severity of disease and prevent manifestation of respiratory allergy.

Parental History of Atopic Diseases and Presence of Allergic Rhinitis and Asthma in Children with Atopic Dermatitis

“…This study also found that chil-dren whose parents previously had allergies were 5 times more likely to develop AD, allergic rhinitis or asthma (9). Similar findings on the association of family AD history with the development of respiratory allergies among children with AD were observed in a cohort of children from Bosnia and Herzegovina (10). While origins of AD are not entirely clear, compelling evidence suggests that parental history of AD can be a risk factor for AD or other atopic diseases, such as allergic rhinitis or asthma in their children (7)(8)(9)(10).…”

“…Similar findings on the association of family AD history with the development of respiratory allergies among children with AD were observed in a cohort of children from Bosnia and Herzegovina (10). While origins of AD are not entirely clear, compelling evidence suggests that parental history of AD can be a risk factor for AD or other atopic diseases, such as allergic rhinitis or asthma in their children (7)(8)(9)(10). We hypothesized that parental history of AD, asthma and allergic rhinitis is associated with presence of allergic rhinitis and asthma comorbidity in children with AD.…”

Atopic Dermatitis and Comorbidity

“…This may be an explanation for the higher proportion of infections in children in this research. The subjects with comorbid allergic rhinitis more often suffer from asthma, which is well known [11,36].…”

“…It was not possible to discern a causal relationship between mental disturbances and skin changes, due to the incomplete records in the medical documentation, in the sense of the time when those illnesses occurred. There is also no information about the existence of disorders in the neurophysiological development of the child, and disorders with a possible genetic basis, which exist in patients suffering from atopic dermatitis [13,36]. These disorders may have led in later life to mental disturbances, but mental disturbances may also have led to skin changes, in the sense of atopic dermatitis.…”

Ефективність Антигістамінних Препаратів I Покоління При Лікуванні Алергічних Захворювань У Дітей

“…При этом была установлена сильная корреляция между распро-страненностью атопического дерматита и частотой аллергического ринита и бронхиальной астмы [22,24,26].…”