Sensitization patterns to food and inhalant allergens in childhood: A comparison of non-sensitized, monosensitized, and polysensitized children
Version of Record online: 13 JUL 2010
© 2010 John Wiley & Sons A/S
Pediatric Allergy and Immunology
Volume 22, Issue 2, pages 166–171, March 2011
How to Cite
Baatenburg de Jong, A., Dikkeschei, L. D. and Brand, P. L. P. (2011), Sensitization patterns to food and inhalant allergens in childhood: A comparison of non-sensitized, monosensitized, and polysensitized children. Pediatric Allergy and Immunology, 22: 166–171. doi: 10.1111/j.1399-3038.2010.00993.x
- Issue online: 20 FEB 2011
- Version of Record online: 13 JUL 2010
- Accepted for publication 23 December 2009
- specific IgE;
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.