Patterns of allergic sensitization and atopic dermatitis from 1 to 3 years: Effects on allergic diseases

Dharma, Christoffer; Lefebvre, Diana L.; Tran, Maxwell; Lou, Wendy; Subbarao, Padmaja; Becker, Allan B.; Mandhane, Piushkumar J.; Turvey, Stuart E.; Sears, Malcolm R.

doi:10.1111/cea.13063

Cited by 56 publications

(63 citation statements)

References 36 publications

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“…2 Compared to this study, the age-matched CHILD study reported sensitization only by SPT; however, the major allergen sources were consistent between these two Canadian cohorts. 2 Compared to this study, the age-matched CHILD study reported sensitization only by SPT; however, the major allergen sources were consistent between these two Canadian cohorts.…”

contrasting

confidence: 57%

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Extract and component‐specific sensitization patterns in Canadian moderate‐to‐severe preschool asthmatics

Hoang

Mashouri

Dai

et al. 2019

Allergy

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contrasting

confidence: 57%

“…2 The same set of SPT solutions was used in both studies. 2 The same set of SPT solutions was used in both studies.…”

mentioning

confidence: 99%

Extract and component‐specific sensitization patterns in Canadian moderate‐to‐severe preschool asthmatics

Hoang

Mashouri

Dai

et al. 2019

Allergy

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“…Except at 3 to 7 years of age, atopic dermatitis was positively associated with prescriptions of ICS, but low RRs suggest that atopic dermatitis had little impact, as also reported by others . Lower prevalence of atopy than LRTI and wheeze (18‐36 months), can partly explain the low AAFs particularly for allergic rhinoconjunctivitis (18‐36 months), although there were moderately associations.…”

Section: Discussionmentioning

confidence: 57%

Airway symptoms and atopy in young children prescribed asthma medications: A large‐scale cohort study

Mikalsen

Dalen

Karlstad

et al. 2019

Pediatric Pulmonology

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Diagnosing asthma and deciding treatment are difficult in young children. An inappropriate and too high prescription rate of inhaled corticosteroids (ICS) is suggested, but how airway symptoms are associated with prescriptions of asthma medication is less known. We studied how strongly wheeze, lower respiratory tract infections (LRTI), and atopic diseases are associated with dispensing of asthma medications during early childhood. We used data from the Norwegian Mother and Child Cohort Study and the Norwegian Prescription Database at four age‐intervals (0‐6, 6‐18, 18‐36 months, and 3‐7 years). Primary outcomes were dispensed asthma medications (no medication, short‐acting β‐2 agonist, or ICS). Relative risks (RRs) and average attributable fractions (AAFs) were estimated. Both wheeze and LRTI were positively associated with both medication groups (0‐6 months: no data on wheeze). The RRs and AAFs were higher for wheeze than LRTI. For ICS, the AAFs (95% CI) for wheeze vs LRTI were: 6 to 18 months: 69.2 (67.2, 71.2)% vs 10.4 (9.0, 11.8)%, 18 to 36 months: 33.0 (30.5, 35.5)% vs 10.0 (8.0, 12.0)%, and 3 to 7 years: 33.7 (31.0, 36.5)% vs 1.2 (0.5, 1.9)%. Except at 3 to 7 years of age, the AAFs were lower for atopic diseases than for LRTI and wheeze. Atopic diseases modified the associations between wheeze and ICS at 18 to 36 months and between LRTI or wheeze and ICS at 3 to 7 years. In conclusion, both wheeze and LRTI were associated with prescriptions of asthma medications in young children, with the strongest associations seen for wheeze. Atopic diseases contributed to these associations only in the oldest age groups.

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“…A child was considered to be sensitised if SPT showed ≥2 mm wheal to any of 4 foods (peanut, milk, egg white or soy) or 13 inhalants (alternaria tenuis, cat hair, dog epithelium, house dust mites (Der.p and Der.f), cockroach, penicillium, cladosporium, aspergillus fumigatus, trees, grasses, weeds and ragweed). Details of skin tests procedure have been described previously …”

Section: Methodsmentioning

confidence: 99%

Diagnosing atopic dermatitis in infancy: Questionnaire reports vs criteria‐based assessment

Dharma

Lefebvre

Tran

et al. 2018

Paediatric Perinatal Epid

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Background Persisting atopic dermatitis (AD) is known to be associated with more serious allergic diseases at later ages; however, making an accurate diagnosis during infancy is challenging. We assessed the diagnostic performance of questionnaire‐based AD measures with criteria‐based in‐person clinical assessments at age 1 year and evaluated the ability of these diagnostic methods to predict asthma, allergic rhinitis and food allergies at age 5 years. Methods Data relate to 3014 children participating in the Canadian Healthy Infant Longitudinal Development (CHILD) Study who were directly observed in a clinical assessment by an experienced healthcare professional using the UK Working Party criteria. The majority (2221; 73.7%) of these children also provided multiple other methods of AD ascertainment: a parent reporting a characteristic rash on a questionnaire, a parent reporting the diagnosis provided by an external physician and a combination of these two reports. Results Relative to the direct clinical assessment, the area under the Receiver Operating Characteristic curve for a parental report of a characteristic rash, reported physician diagnosis and a combination of both were, respectively, 0.60, 0.69 and 0.70. The strongest predictor of asthma at 5 years was AD determined by criteria‐based in‐person clinical assessment followed by the combination of parental and physician report. Conclusions These findings suggest that questionnaire data cannot accurately substitute for assessment by experienced healthcare professionals using validated criteria for diagnosis of atopic dermatitis. Combining the parental report with diagnosis by a family physician might sometimes be appropriate (eg to avoid costs of a clinical assessment).

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Patterns of allergic sensitization and atopic dermatitis from 1 to 3 years: Effects on allergic diseases

Abstract: SummaryBackground: While allergic sensitization and atopic dermatitis (AD) are known to

Cited by 56 publications

References 36 publications

Extract and component‐specific sensitization patterns in Canadian moderate‐to‐severe preschool asthmatics

Extract and component‐specific sensitization patterns in Canadian moderate‐to‐severe preschool asthmatics

Airway symptoms and atopy in young children prescribed asthma medications: A large‐scale cohort study

Diagnosing atopic dermatitis in infancy: Questionnaire reports vs criteria‐based assessment

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