Allergen Profile, Pediatric, Three to Six Years

It can be difficult to diagnose allergies in young children, since they are often unable to verbalize their symptoms.¹ Moreover, the symptoms of allergic disease can overlap with those of bacterial and viral infections that are common in children. Testing for allergen-specific IgE levels can be useful in assessing the potential that an atopic disposition might play a role in fostering chronic sinusitis or dermatitis in these patients. Accurate diagnosis of the allergen sensitivity can allow the clinician to develop an optimal therapeutic approach. Early intervention can dramatically improve the child's symptoms and can reduce the chances of developing asthma in the future.^2-5 The progressive development of increasingly debilitating allergic disease as an atopic child grows into adulthood has been referred to by some researchers as the “allergy march.”^3,4,6 Children with a genetic predisposition towards the development of allergy (ie, atopic children) often start with sensitivity to foods that exhibits itself as atopic dermatitis during the first two years of life. After age two, these children often develop sensitivity to inhalant allergens, such as pollens or dust mites, producing allergenic rhinitis.^3,6 Clinical studies have shown that children who develop atopic dermatitis^2,4 or allergic rhinitis^2,3,7 at a young age have an increased tendency to develop asthma as they grow older. Asthma is a chronic inflammatory disease that is characterized by airway obstruction and constriction of the bronchi of the lungs.^2,7,8 Asthma can be a debilitating condition and results in more pediatric hospital admissions than any other cause.⁷ Over 75% of patients with asthma can be shown to have sensitivity to at least one common allergen⁷ or suffer from allergic rhinitis.⁶ Atopy is the strongest identifiable predisposing factor for the development of asthma.⁹ It has been hypothesized that allergic sensitization at a young age results in a state of chronic airway inflammation^5,10 which, in turn, increases the child's susceptibility to nasal (sinusitis) and ear infections (otitis media). In fact, approximately 50% of children with chronic otitis media can be shown to have nasal allergy.¹⁰ Chronic allergy-mediated inflammation and associated infections are thought to cause mucosal damage and lung remodeling that can ultimately lead to asthma. A number of studies indicate that early treatment of allergy can change the course of disease progression.^3,4,5 Clinical intervention seems to be most effective if the treatments are initiated before the age of six, increasing the importance of early diagnostic testing.⁹