Sensitization patterns to food and inhalant allergens in childhood: A comparison of non-sensitized, monosensitized, and polysensitized children

• Published in: Pediatric allergy and immunology Vol. 22; no. 2; pp. 166 - 171
• Main Authors: Baatenburg de Jong, Adriana, Dikkeschei, Lambert D., Brand, Paul L. P.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.2011; Blackwell; Wiley Subscription Services, Inc
• Subjects: Adolescent; Age; Age Factors; Allergens; Allergens - immunology; Allergies; Animals; Animals, Domestic; Arachis hypogaea; Atopy; Biological and medical sciences; Child; Child, Preschool; Children; Children & youth; Cow's milk; Cross-reactivity; Dermatophagoides pteronyssinus; Female; Food; Food - adverse effects; Food hypersensitivity; Fundamental and applied biological sciences. Psychology; Fundamental immunology; General aspects; Grasses; Humans; Hypersensitivity - blood; Hypersensitivity - epidemiology; Hypersensitivity - immunology; Immunoglobulin E; Immunoglobulin E - blood; Immunoglobulin E - immunology; Infant; Inhalants; Male; Medical sciences; Mites; Netherlands - epidemiology; Nuts; Pollen; polysensitization; Retrospective Studies; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; sensitization; Soybeans; specific IgE; Trees; Triticum aestivum; Netherlands; Human; Immunopathology; Pediatrics; Food allergen; Immunology; Specific IgE; polysensitization; Sensitization; Child; Comparative study; Allergen
• ISSN: 0905-6157; 1399-3038
• DOI: 10.1111/j.1399-3038.2010.00993.x

To cite this article: Baatenburg de Jong A, Dikkeschei LD, Brand PLP. Sensitization patterns to food and inhalant allergens in childhood: A comparison of non‐sensitized, monosensitized, and polysensitized children. Pediatr Allergy Immunol 2011; 22: 166–171. The clinical interpretation of children sensitized to numerous allergens is challenging. We examined differences between children sensitized to zero, one, or more allergens. This was a retrospective analysis of all specific IgE tests in children 0–18 yrs of age sent to our laboratory by general practitioners and hospital‐based specialists for allergy testing between 1990 and 2003. Of all 9044 children tested, 5439 (60.1%) were not sensitized to any of the aeroallergens or food allergens tested. Three thousand six hundred and five children (39.9%) had one or more positive specific IgE tests, 1120 of which (31.1%) were monosensitized (73% to aeroallergens and 27% to food allergens), 1709 (47.4%) were sensitized to two to four allergens, and 776 (21.5%) to five or more allergens (polysensitization). Polysensitization was more common in children 4–11 yrs of age (24.8%) than in younger (18.7%) or older children (18.3%, p < 0.001), and more common in boys (9.8%) than in girls (7.3%, p < 0.001). Median total IgE values increased with increasing number of positive specific IgE tests (p < 0.001). House dust mite more commonly showed monosensitization (22.2%) than other aeroallergens (grass pollen 10.5%, tree pollen 3.6%, cat 2.9%, and dog 1.5%); cow’s milk (27.6%) more commonly than other food allergens (hen’s egg 9.7%, peanut 4.6%, wheat 0.8%, soy 0.7%). Between 55.7% (cow’s milk) and 87.9% (soy) of children sensitized to food were cosensitized to aeroallergens, while only 25.4% (house dust mite) to 39.5% (dog) of children sensitized to aeroallergens were cosensitized to food. Polysensitization is common in children, in particular in boys. It is most common in school‐aged children. The strong association with total serum IgE values and the striking cosensitization between biologically unrelated allergens suggest that polysensitization is the expression of a distinct clinical, more severe, atopic phenotype, and not of biologic cross‐reactivity to similar allergens.