Source: Eur J Ophthalmol  |  Posted 6 years ago

By Norra MacReady

MUNICH, GERMANY -- July 5, 2005 -- Children with atopic dermatitis often have allergies to multiple foods, researchers reported here on June 30[^]th[] at the World Allergy Congress (WAC).

The usual approach to identifying food allergies is to eliminate milk and eggs from the child's diet, said Kristiina Turjanmaa, MD, Chief, Allergy Unit, Dermatology Clinic, Tampere University Hospital, Tampere, Finland. But in her experience, she said, as many as 50% of patients can be symptom-free by 1 year of age through stepwise elimination of possible dietary culprits other tan milk and eggs.

Even children with very high immunoglobulin E titers to the offending allergen respond well to this method.

During a poster session she presented an analysis of skin prick test results to various foods, dog and cat dander, and birch pollen performed on 604 children ranging in age from birth to 1 year and 243 children from 1 to 2 years. The test was considered positive when the mean wheal diameter was at least 3 mm and the negative control was 0.

Egg white allergies were the most common, with 35% of the younger children and 29% of the older children testing positive. Cow's milk allergies were found in 18% of younger and 13% of older children.

However, 14% of younger children and 13% of older children had a positive reaction to wheat, 11% in both groups reacted to barley, and 14% and 13% of children, respectively, had a positive reaction to rye. Smaller percentages of children in both age groups had positive results to peanuts, hazelnuts, fish, mustard, and potatoes. Dog dander elicited positive responses in 6% and 8% of children, respectively, and 6% in both groups reacted positively to cat dander. Birch pollen allergies were found in 1% of younger and 5% of older children.

"These findings suggest that young children may be sensitised to multiple food allergens at the same time," Dr. Turjanmaa said. "If a child is sensitive to wheat, rye, and barley, then I'm quite positive that a cereal allergy is behind their symptoms and I start them on the elimination diet."

Many children with atopic dermatitis also have gastrointestinal symptoms, which makes identification and elimination of the sources of atopic inflammation particularly urgent, she explained in an interview.

When the dermatological symptoms are resolved, the gastrointestinal symptoms often subside as well. Therefore, she said, her goal is to eliminate the atopic dermatitis as completely as possible. "If steroids and emollients have not helped after 1 month, I try to diagnose the allergies and begin appropriate management," she added.

[Presentation title: Skin Prick Test Results to Multiple Allergens in 847 Children <2 Years of Age With Atopic Eczema. Poster 905]