Eseverri J L, Cozzo M, Marín A M, Botey J
Servei d'Al Iergologia i Immunologia Clínica Pediàtrica, Hospital Universitari Materno-Infantil Vall d'Hebron, Barcelona.
Allergol Immunopathol (Madr). 1998 May-Jun;26(3):90-7.
An increase in allergic diseases in Western societies has been observed in all epidemiological studies. Various risk factors have been invoked to explain this increase, but the results are still inconclusive. We examined the type of patients who visited a hospital pediatric allergology unit in terms of the type of pathology presented, environmental factors, and time from the onset of symptoms until referral for allergy study. We evaluated 200 children ranging in age from 1 month to 15 years who were distributed by pathology: 119 referrals for respiratory manifestations (asthma, rhinitis, coughing, ...), 46 for food-related pathology, and 35 for adverse reactions attributed to medications. Among the risk factors, 69% of the children had a family history, 63.5% were exposed to smoking, and all of the patients were from urban and urban-industrial areas. We found no relation between the type of pathology and birth month. The natural history of allergic disease showed the following sequence: food allergy--respiratory allergy--medication allergy. In every case there was an important delay in diagnosis. The patients who visited our department soonest were infants (for presumptive allergy to cow milk protein or suspected adverse reaction to medications). It is evident that in recent years we are seeing a major increase in allergic diseases, particularly in industrialized countries. From a clinical point of view, manifestations such as asthma, rhinitis, and atopic dermatitis are increasing, which all working groups attribute to an increase in the prevalence of allergy. Epidemiological studies of large population samples use non-standard methods, with different selection criteria, ethnic breakdown and geographic differences. This makes it difficult to compare available data. Therefore, we think that it would be advisable if epidemiological studies would attempt to follow a model, which would facilitate the comparison of studies. Our aim was to evaluate the type of patients who required allergy studies in relation to the pathologies that they present and the different diagnostic methods to determine the presence of false allergies or non-allergies, the delay until study, most frequent pathologies, and environment. We report the data obtained from a sample of 200 children who visited our department for the first time in the period of a natural year.
所有流行病学研究均观察到西方社会过敏性疾病有所增加。人们提出了各种风险因素来解释这种增加，但结果仍无定论。我们根据所呈现的病理类型、环境因素以及从症状出现到转诊进行过敏研究的时间，对前往医院儿科过敏科就诊的患者类型进行了检查。我们评估了200名年龄在1个月至15岁之间的儿童，这些儿童按病理情况分类如下：119例因呼吸道表现（哮喘、鼻炎、咳嗽等）转诊，46例因食物相关病理情况转诊，35例因药物不良反应转诊。在风险因素方面，69%的儿童有家族病史，63.5%的儿童接触过吸烟环境，所有患者均来自城市及城市工业区。我们发现病理类型与出生月份之间没有关联。过敏性疾病的自然病程呈现以下顺序：食物过敏——呼吸道过敏——药物过敏。在每种情况下，诊断都有重要延迟。最早前来我们科室就诊的患者是婴儿（疑似对牛奶蛋白过敏或疑似药物不良反应）。显然，近年来我们看到过敏性疾病大幅增加，尤其是在工业化国家。从临床角度来看，哮喘、鼻炎和特应性皮炎等表现正在增加，所有工作组都将其归因于过敏患病率的上升。对大量人群样本的流行病学研究采用非标准方法，有不同的选择标准、种族分类和地理差异。这使得难以比较现有数据。因此，我们认为，如果流行病学研究尝试遵循一种模式，将有助于研究的比较，这将是可取的。我们的目的是评估需要进行过敏研究的患者类型，以及他们所呈现的病理情况、用于确定假过敏或非过敏情况的不同诊断方法、研究延迟情况、最常见的病理情况和环境。我们报告了在一自然年内首次前来我们科室就诊的200名儿童样本所获得的数据。
