Coexistence of allergic diseases: patterns and frequencies
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Published on: June 4, 2017
Hai-Lun Sun1, Chih-Jung Yeh, Min-Sho Ku
1Department of Pediatrics, Chung Shan Medical University Hospital, Chung Shan Medical University, Taichung, Taiwan. sunhailun@yahoo.com.tw
Insights
The classic atopic march progression of allergic diseases is rare in children, observed in only 4.2% of cases. Early onset of allergic disease before age 2.79 increases the likelihood of developing further allergic conditions.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology of Allergic Diseases
- Immune System Development
Background:
- The atopic march hypothesis posits a common progression of allergic diseases: atopic dermatitis, followed by allergic asthma and allergic rhinitis.
- Understanding the frequency and patterns of this progression in children is crucial for early intervention and management.
Purpose of the Study:
- To investigate the actual frequency of the classic atopic march progression in a pediatric cohort.
- To analyze the onset age, disease intervals, and overall pattern of allergic disease progression.
Main Methods:
- Retrospective cohort study utilizing the National Health Insurance Research Database (1996-2008).
- Inclusion of 10,729 children aged <5 years from a random sample of 200,000 individuals.
- Confirmation of allergic diseases via physician diagnosis based on international disease coding.
Main Results:
- Only 4.2% of pediatric cases exhibited the classic atopic march progression.
- Children with multiple allergic diseases had a significantly earlier onset age compared to those with a single disease (p < 0.05).
- Early onset (before 2.79 years) predicted subsequent allergic disease development within 1.96-2.5 years.
Conclusions:
- The classic atopic march is not the predominant pathway for allergic disease development in children.
- Early-onset allergic conditions in early childhood are strong indicators for the potential development of additional allergic diseases.
- Age of onset is a critical factor in predicting the trajectory of allergic disease progression.
Abstract:
The atopic march hypothesis suggests that allergy diseases often progress from atopic dermatitis to allergic asthma, and allergic rhinitis. How often can the classic progression of allergic diseases be observed in the pediatric patient population? This study aimed to observe the pattern of allergic diseases progression, onset age, disease intervals, and frequency of the allergic march. Data from the National Health Insurance Research Database in the period 1996-2008 were used to obtain a cohort of children with allergic disease. Physician's diagnosis was used to confirm the allergic disease based on the international disease coding. The age of disease onset was compared. There were 10,729 children aged <5 years enrolled from the 200,000 individuals randomly sampled in 2000. Of these, 5866 (54.7%) had been diagnosed with at least one allergic disease. The rate of only one of three diseases diagnosed was 29.8% (3195 patients), whereas 18.8% had two allergic diseases and 6.1% had all three allergic diseases. Only 4.2% of cases matched the allergic march. Patients with more than one disease had earlier onset age than those who had only one disease (4.17 versus 2.79 and 2.32 years old; p < 0.05). The allergic march accounts for only 4.2% in this study. A patient with only one allergic disease after the age of 4.17 years will not have another allergic disease until the age of 12 years. However, a patient with an allergic disease before 2.79 years old will probably have another allergic disease in 1.96-2.5 years.
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