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Prevalence of IgE sensitization in Danish children with suspected asthma
Benjamin Hoffmann-Petersen1, Arne Høst, Kirsten Toksvig Larsen
1Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
Insights
High IgE sensitization is common in children with confirmed asthma, affecting over 67%. Allergy testing is crucial for accurate asthma diagnosis and appropriate treatment, especially before prescribing inhaled corticosteroids.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Clinical Diagnostics
Background:
- Asthma diagnosis in children can be challenging.
- Identifying allergic sensitization is key to understanding asthma triggers.
- Prevalence of IgE sensitization varies among pediatric populations.
Purpose of the Study:
- To determine the prevalence of IgE sensitization in Danish children with suspected asthma.
- To characterize the specific patterns of allergic sensitization in this cohort.
- To evaluate the correlation between skin prick testing (SPT) and serum IgE (s-IgE) measurements.
Main Methods:
- Cross-sectional study of 1744 children (0-15 years) with suspected asthma.
- Utilized questionnaires, clinical examinations, SPT, and s-IgE measurements for 17 allergens.
- Data collected from pediatric outpatient clinics in southern Denmark (2003-2005).
Main Results:
- Asthma confirmed in 1024 children; 67.5% showed sensitization to at least one allergen.
- Highest sensitization rates observed for indoor allergens (51.8%), followed by outdoor (36.2%) and food allergens (31.1%).
- Discrepancies noted in inhaled corticosteroid (ICS) use, with some children without asthma receiving ICS and others with verified asthma not.
Conclusions:
- A high prevalence of IgE sensitization exists in children with confirmed asthma.
- Supports the recommendation for allergy testing in all children diagnosed with asthma.
- Highlights the importance of accurate asthma diagnosis prior to initiating continuous ICS treatment.
Objective:
The aim of this article was to estimate the prevalence of IgE sensitization in Danish children with suspected asthma and to characterize the pattern of sensitization.
Study Design:
We performed a cross-sectional study including 1744 children from 0 to 15 yr suspected of asthma who were referred to pediatric outpatient clinics in the region of southern Denmark from 2003 to 2005. The children were subjected to an extensive questionnaire-based interview, clinical examination, and both skin prick testing (SPT) and IgE measurements for 17 allergens.
Results:
Asthma was confirmed in 1024 of the 1744 children. Among the children in whom the asthma diagnosis was confirmed, sensitization to one or more of the 17 allergens tested was found in 67.5% by either SPT or s-IgE ≥ class 2. Sensitization to any food allergen was found in 31.1%, to any outdoor allergen in 36.2%, and to any indoor allergen in 51.8%. Sensitization to cockroach and latex was rare. We found a weak correlation between SPT and s-IgE among food allergens and a more distinct correlation among inhalant allergens. Surprisingly, 30.1% of children in whom the asthma diagnosis was disproven used inhaled corticosteroids (ICS). On the contrary, 32.5% of the children for whom the asthma diagnosis was verified were not treated with ICS.
Conclusion:
We have found a high prevalence of sensitization among children with verified asthma. Our study supports relevant allergy testing in all children with verified asthma and emphasizes the importance of a thorough asthma diagnosis before prescribing continuous inhaled corticosteroids to children.
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