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Published on: August 8, 2014
Perceived Versus Actual Aeroallergen Sensitization in Urban Children
Michele N Pham1, Jade Andrade2, Michelle Mishoe1
1Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY.
Insights
Children often misjudge their allergies. While perceived allergies to cat, dog, dust, or grass align with actual sensitization, many children without perceived allergies are still sensitized to common aeroallergens.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Clinical Diagnostics
Background:
- Allergy testing can reveal sensitization to aeroallergens that differs from what individuals report.
- Understanding the discrepancy between perceived and actual sensitization is crucial for accurate diagnosis and management.
Purpose of the Study:
- To assess the agreement between perceived and actual sensitization to specific aeroallergens in urban children.
- To identify factors influencing the concordance of self-reported and clinically confirmed allergies.
Main Methods:
- Serum specific IgE levels and detailed questionnaires on perceived sensitization were collected from 253 children in New York.
- Agreement was evaluated using Cohen's kappa, and multivariable logistic regression analyzed associations with confounders.
Main Results:
- 80.2% of children had actual sensitization, while 63.6% reported perceived sensitization.
- Fair agreement was observed for most aeroallergens, with highest concordance for cat dander and dust.
- Perceived sensitization strongly predicted actual sensitization for cat, dog, dust, and grass allergens, but many unsensitized children were still allergic.
Conclusions:
- Perceived sensitization to common aeroallergens like cat, dog, dust, and grass generally correlates with actual IgE-mediated sensitization in children.
- A significant proportion of children lack perceived sensitization yet exhibit actual sensitization, highlighting the need for objective testing.
Background:
Individuals often report allergy to specific aeroallergens, but allergy testing can reveal disparate sensitization.
Objective:
To characterize the agreement between perceived and actual sensitization to individual aeroallergens in an urban pediatric population.
Methods:
A total of 253 children were enrolled from pediatric clinics in New York, NY. Detailed questionnaires regarding perceived sensitization and serum specific IgE measurements to 10 common aeroallergens were completed. Agreement between perceived and actual sensitization (sIgE ≥ 0.35 kUA/L) to individual aeroallergens was assessed by Cohen's kappa. Multivariable logistic regression models adjusted for potential confounders were used to test for associations between perceived and actual sensitization.
Results:
A total of 161 (63.6%) of 253 children reported perceived sensitization to 1 or more aeroallergen, and 203 (80.2%) were actually sensitized to 1 or more aeroallergen. Agreement between perceived and actual aeroallergen sensitization was fair for most aeroallergens, with greatest agreement for cat dander (κ, 0.42; 95% CI, 0.32-0.53) and dust (κ, 0.32; 95% CI, 0.20-0.44). Models adjusted for potential confounders showed nearly 6-fold odds of sensitization to cat dander given perceived cat allergy (adjusted odds ratio, 5.82; 95% CI, 2.91-11.64), and over 2-fold odds of sensitization to Dermatophagoides pteronyssinus, Dermatophagoides farinae, dog dander, or grass pollen given perceived sensitization to their respective allergens. Among children with no perceived sensitization, actual sensitization ranged from 5.4% to 30.4%, and was more common for indoor versus outdoor allergens, including cockroach.
Conclusions:
Children who perceive allergen sensitization to cat, dog, dust, or grass are likely to demonstrate actual sensitization to these individual allergens. Children with no perceived sensitization to allergens are nonetheless frequently sensitized.
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