Allergy and Immunology Clinic, Pulmonary Institute, Rabin Medical Center, Petah Tiqva 49100, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatr Allergy Immunol. 2009 Dec;20(8):757-62. doi: 10.1111/j.1399-3038.2009.00863.x. Epub 2009 Apr 21.
The question of whether atopic diseases are a risk factor for allergic reactions to insect sting is still unresolved. The aim of this study was to evaluate the association between atopic diseases (asthma, allergic rhinitis, atopic eczema) and allergic reactions to insect stings among schoolchildren in Israel. A self-report questionnaire of the International Study of Asthma and Allergies in Childhood was administered to a national sample of 13-14-yr-old schoolchildren. Questions regarding reactions to insect stings were added. A total of 10,021 questionnaires were available for analysis. Among the children who reported insect stings (56.3%), the prevalence of current asthma was 6.0%, of allergic rhinitis, 10.5%, and of atopic eczema, 8.7%, with no significant differences from the whole study population. Among children with any of the atopic diseases, 36.9% reported an allergic reaction to insect sting compared to 24.8% of the non-atopic children (p < 0.0001). On multivariate analysis, asthma, allergic rhinitis, and atopic eczema were found to be significant risk factors for allergic reactions of any severity. Children in the atopic group had a significantly higher rate of severe allergic reactions than the non-atopic children, and relatively higher rates of milder ones (p < 0.0001). Asthmatic patients with severe allergic reactions had more parameters of severe asthma than asthmatic patients with mild or no reactions. In conclusions, allergic diseases are associated with a higher rate and greater severity of allergic reactions to insect sting in children. The severity of the allergic reaction is related to the severity of the asthma symptoms.
特应性疾病是否是昆虫叮咬过敏反应的危险因素仍未解决。本研究旨在评估特应性疾病（哮喘、过敏性鼻炎、特应性皮炎）与以色列学龄儿童对昆虫叮咬过敏反应之间的关系。对全国范围内 13-14 岁的学龄儿童进行了儿童哮喘和过敏国际研究的自我报告问卷调查，并添加了有关昆虫叮咬反应的问题。共分析了 10021 份问卷。在报告有昆虫叮咬史的儿童中（56.3%），当前哮喘的患病率为 6.0%，过敏性鼻炎为 10.5%，特应性皮炎为 8.7%，与整个研究人群无显著差异。在患有任何特应性疾病的儿童中，有 36.9%报告对昆虫叮咬有过敏反应，而非特应性儿童的这一比例为 24.8%（p<0.0001）。多变量分析显示，哮喘、过敏性鼻炎和特应性皮炎是任何严重程度过敏反应的显著危险因素。特应性组的儿童发生严重过敏反应的比率明显高于非特应性儿童，而轻度或无过敏反应的儿童的比率相对较高（p<0.0001）。有严重过敏反应的哮喘患者比有轻度或无反应的哮喘患者有更多的严重哮喘参数。总之，过敏疾病与儿童对昆虫叮咬过敏反应的发生率和严重程度较高有关。过敏反应的严重程度与哮喘症状的严重程度有关。
