Department of Pediatrics, Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey.
Allergy Asthma Proc. 2013 Jul-Aug;34(4):356-361. doi: 10.2500/aap.2013.34.3655.
Aeroallergens may trigger symptoms in sensitized children with asthma. Documentation of sensitization is crucial to enable effective implementation of measures to prevent asthma exacerbations. To document the sensitization patterns of very young children (≤2 years) with asthma, we retrospectively analyzed the skin-prick test (SPT) results of the largest referral center in the country. During a 4-year period, 432 children (median age, 1.21 years; male/female, 2.35) were referred. All patients had recurrent wheezing attacks and good response to inhaled bronchodilators and were diagnosed with asthma by their referring physician. SPT with eight aeroallergens (grass mix, weed mix, tree mix, mold mix, house-dust mite, cockroach, cat, and dog) was performed in 209 patients (full panel group) and the remaining 223 were tested only with a mixture of two house-dust mites (Dermatophagoides pteronyssinus and Dermatophagoides farinae; house-dust mite group). The sensitization rates in house-dust mite and full panel groups were 3.2% (7/223) and 3.3% (7/209), respectively. Univariate and multivariate modeling was unable to identify a predictor for the presence of aeroallergen sensitization. During first 2 years of life, low rates of aeroallergen sensitization and lack of predictors of sensitization in children with asthma suggest that skin testing for aeroallergens may not be a routine procedure. When there is a high index of suspicion, testing only for indoor aeroallergens including house-dust mites, molds, and pets may identify the majority of sensitized children.
过敏原可能会引发哮喘患儿的症状。记录致敏情况对于实施预防哮喘加重的措施至关重要。为了记录患有哮喘的非常年幼的儿童(≤2 岁)的致敏模式,我们回顾性分析了全国最大转诊中心的皮肤点刺试验(SPT)结果。在 4 年期间,共有 432 名儿童(中位数年龄为 1.21 岁;男女比例为 2.35)被转诊。所有患者均有反复喘息发作,对吸入性支气管扩张剂反应良好,并由转诊医生诊断为哮喘。209 名患者(完整组)进行了 8 种过敏原(草混合物、杂草混合物、树木混合物、霉菌混合物、屋尘螨、蟑螂、猫和狗)的 SPT,其余 223 名患者仅用两种屋尘螨(屋尘螨和粉尘螨混合物)进行了测试。屋尘螨组和完整组的致敏率分别为 3.2%(7/223)和 3.3%(7/209)。单变量和多变量模型均无法确定过敏原致敏的预测因素。在生命的前 2 年,哮喘儿童中过敏原致敏率较低且缺乏致敏预测因素,这表明皮肤点刺试验可能不是常规程序。当高度怀疑时,仅对室内过敏原(包括屋尘螨、霉菌和宠物)进行测试可能会识别出大多数致敏儿童。