The natural course of sensitization and allergic diseases from childhood to adulthood

Nissen, Susanne P; Kjær, Henrik Fomsgaard; Høst, Arne; Nielsen, Jan; Halken, Susanne

doi:10.1111/pai.12108

Cited by 107 publications

(122 citation statements)

References 30 publications

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“…Therefore eczema in infancy must be considered a serious warning sign for lasting allergic problems rather than a transient condition, although eczema usually gets less severe with time [28]. Atopic disease during childhood often persists into adulthood [9]. The reported risk for children with atopic eczema of developing asthma varies between different studies.…”

Section: Discussionmentioning

confidence: 99%

“…Especially in countries with a western life style the prevalence of allergy in childhood has increased remarkably in recent decades [2], [4], [5]. The “atopic march” is a term that has been used to describe the progression from atopic eczema and food allergy during infancy to ARC and subsequently to asthma later in childhood [6]–[9]. Previous studies have shown that children with atopic eczema or those sensitized to allergens in early childhood more often develop ARC and asthma [8], [10]–[13].…”

Section: Introductionmentioning

confidence: 99%

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Severe Eczema in Infancy Can Predict Asthma Development. A Prospective Study to the Age of 10 Years

Ekbäck

Tedner²,

Devenney

et al. 2014

PLoS ONE

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BackgroundChildren with atopic eczema in infancy often develop allergic rhinoconjunctivitis and asthma, but the term “atopic march” has been questioned as the relations between atopic disorders seem more complicated than one condition progressing into another.ObjectiveIn this prospective multicenter study we followed children with eczema from infancy to the age of 10 years focusing on sensitization to allergens, severity of eczema and development of allergic airway symptoms at 4.5 and 10 years of age.MethodsOn inclusion, 123 children were examined. Hanifin-Rajka criteria and SCORAD index were used to describe the eczema. Episodes of wheezing were registered, skin prick tests and IgE tests were conducted and questionnaires were filled out. Procedures were repeated at 4.5 and 10 years of age with additional examinations for ARC and asthma.Results94 out of 123 completed the entire study. High SCORAD points on inclusion were correlated with the risk of developing ARC, (B = 9.86, P = 0.01) and asthma, (B = 10.17, P = 0.01). For infants with eczema and wheezing at the first visit, the OR for developing asthma was 4.05(P = 0.01). ARC at 4.5 years of age resulted in an OR of 11.28(P = 0.00) for asthma development at 10 years.ConclusionThis study indicates that infant eczema with high SCORAD points is associated with an increased risk of asthma at 10 years of age. Children with eczema and wheezing episodes during infancy are more likely to develop asthma than are infants with eczema alone. Eczema in infancy combined with early onset of ARC seems to indicate a more severe allergic disease, which often leads to asthma development. The progression from eczema in infancy to ARC at an early age and asthma later in childhood shown in this study supports the relevance of the term “atopic march”, at least in more severe allergic disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Severe Eczema in Infancy Can Predict Asthma Development. A Prospective Study to the Age of 10 Years

Ekbäck

Tedner²,

Devenney

et al. 2014

PLoS ONE

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“…1 The most prevalent of these conditions are atopic eczema/dermatitis, asthma and allergic rhinitis. [2][3][4][5] These result in a significant impact at the personal level because of impaired quality of life, a significant impact on family and friends, on the healthcare system because of increased medical costs and at a societal level because of lost productivity through presenteeism and absenteeism. 6,7 Currently, allergy is often not well recognized and is as a result poorly managed.…”

Section: Introductionmentioning

confidence: 99%

Challenges in the implementation of the EAACI AIT guidelines: A situational analysis of current provision of allergen immunotherapy

Ryan

Wijk

Angier

et al. 2017

Allergy

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“…Such a gold standard could probably be the evidence of sensitization by specific IgE. 10 Checking specific IgE is now a requirement of assessment of the patient with asthma. When studying the observed differences between annual point prevalence and cumulative life-time prevalence, a greater understanding of the natural course of these atopic disorders is required.…”

Section: Discussionmentioning

confidence: 99%

Reliably estimating prevalences of atopic children: an epidemiological study in an extensive and representative primary care database

Pols

Nielen

Korevaar

et al. 2017

npj Prim Care Resp Med

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Electronic health records stored in primary care databases might be a valuable source to study the epidemiology of atopic disorders and their impact on health-care systems and costs. However, the prevalence of atopic disorders in such databases varies considerably and needs to be addressed. For this study, all children aged 0–18 years listed in a representative primary care database in the period 2002–2014, with sufficient data quality, were selected. The effects of four different strategies on the prevalences of atopic disorders were examined: (1) the first strategy examined the diagnosis as recorded in the electronic health records, whereas the (2) second used additional requirements (i.e., the patient had at least two relevant consultations and at least two relevant prescriptions). Strategies (3) and (4) assumed the atopic disorders to be chronic based on strategy 1 and 2, respectively. When interested in cases with a higher probability of a clinically relevant disorder, strategy 2 yields a realistic estimation of the prevalence of atopic disorders derived from primary care data. Using this strategy, of the 478,076 included children, 28,946 (6.1%) had eczema, 29,182 (6.1%) had asthma, and 28,064 (5.9%) had allergic rhinitis; only 1251 (0.3%) children had all three atopic disorders. Prevalence rates are highly dependent on the clinical atopic definitions used. The strategy using cases with a higher probability of clinically relevant cases, yields realistic prevalences to establish the impact of atopic disorders on health-care systems. However, studies are needed to solve the problem of identifying atopic disorders that are missed or misclassified.

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The natural course of sensitization and allergic diseases from childhood to adulthood

Abstract: The results support the concept of the allergic march. Allergic diseases are not only occurring in childhood but persist into adulthood.

Cited by 107 publications

References 30 publications

Severe Eczema in Infancy Can Predict Asthma Development. A Prospective Study to the Age of 10 Years

Severe Eczema in Infancy Can Predict Asthma Development. A Prospective Study to the Age of 10 Years

Challenges in the implementation of the EAACI AIT guidelines: A situational analysis of current provision of allergen immunotherapy

Reliably estimating prevalences of atopic children: an epidemiological study in an extensive and representative primary care database

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