Abstract
Amaç: Atopik yürüyüş, alerjik hastalıkların atopik dermatitten (AD) alerjik astım ve rinite ilerlemesini açıklayan bir modeldir. Çalışmamızda AD tanısı konan ve en az 5 yaşına kadar takip edilen hastalarda alerjen duyarlılığı ve alerjik hastalık varlığını değerlendirirken, klasik atopik yürüyüş tanımının beklentilere ne kadar cevap verdiğini araştırmak amaçlanmıştır.
Gereç ve Yöntemler: Başvuru sırasında yaşları 2 yaş ve altında olan, AD tanılı, ve en az 5 yaşına kadar düzenli olarak takip edilen hastaların dosya kayıtları geriye dönük olarak incelendi. Klinik ve laboratuvar bulguları kaydedildi. Hastaların 5 yaşında iken alerjik hastalık varlığı ve alerjen duyarlılık durumları not edildi.
Bulgular: Kriterleri karşılayan AD tanılı 41 hasta belirlendi. Başvuru sırasında 28 (%68.3) hastada besin duyarlılığı saptandı. Hastaların 5 yaşına geldiğinde 13 (%31.7)’ünde astım, 12 (%29.2)’ sinde alerjik rinit tanısı saptandı.
Sonuç: AD’li hastalarda astım ve alerjik rinit sıklığı normal popülasyon verilerine göre daha yüksek bulundu. Ancak gıda duyarlılığı ile astım ve/veya alerjik rinit gelişimi arasında bir ilişki gösterilemedi. AD’de etkili cilt bakımının, alerjik hastalıkların gelişmesine karşı koruyucu olabileceği düşünüldü. Klinisyenlerin çocuklarda atopik hastalık modellerinin heterojenliğini anlamaları ve bu değişkenliği ortadan kaldırabilmeleri için AD’li bebeklerin sonraki yaşamlarında takip edilmeleri faydalı olacaktır.
References
- Aksu K, Arga M, Asilsoy S Avcil S, Çetinkaya F, Civelek E, et al. Diagnosis and management of atopic dermatitis: national guideline 2018. Asthma Allergy Immunol 2018;16:1-130.
- Uysal P, Uzuner N. How is atopic dermatitis diagnosed in children? İzmir Dr. Behçet Uz Çocuk Hastanesi Dergisi 2013;3:1-11.
- Bawany F, Beck LA, Järvinen KM. Halting the march: primary prevention of atopic dermatitis and food allergies. J Allergy Clin Immunol Pract 2020;8: 860-75.
- Aw M, Penn J, Gauvreau GM, Lima H, Sehmi R. Atopic March: Collegium Internationale Allergologicum Update 2020. Int Arch Allergy Immunol 2020;181: 1-10.
- Busse WW. The atopic march: fact or folklore? Ann Allergy Asthma Immunol 2018;120:116-8.
- Rudzki E, Samochocki Z, Rebandel P, Saciuk E, Gałecki W, Raczka A, et al. Frequency and significance of the major and minor features of Hanifin and Rajka among patients with atopic dermatitis. Dermatology 1994; 189:41-6.
- Just J, Deslandes‐Boutmy E, Amat F, Desseaux K, Nemni A, Bourrat E, et al. Natural history of allergic sensitization in infants with early‐onset atopic dermatitis: results from ORCA Study. Pediatr Allergy Immunol 2014; 25:668-63.
- Bieber T, D’Erme AM, Akdis C, Traidl-Hoffmann C, Lauener R, Schäppi G, et al. Clinical phenotypes and endophenotypes of atopic dermatitis: Where are we, and where should we go? J Allergy Clin Immunol 2017; 139: 58-64.
- Tezcan I, Berkel AI, Ersoy F, Sanal O. Sağlıklı Türk çocukları ve erişkinlerde turbidometrik yöntemle bakılan serum immunoglobulin düzeyleri. Çocuk Sağlığı ve Hastalıkları Dergisi 1996; 39;649-56.
- Bantz SK, Zhu Z, Zheng T. The Atopic March: Progression from atopic dermatitis to allergic rhinitis and asthma. J Clin Cell Immunol 2014;5: 202.
- Eller E, Kjaer HF, Høst A, Andersen KE, Bindslev-Jensen C. Food allergy and food sensitization in early childhood: results from the DARC cohort. Allergy 2009; 64: 1023-9.
- Tsakok T, Marrs T, Mohsin M, Baron S, du Toit G, Till S, et al. Does atopic dermatitis cause food allergy? A systematic review. J Allergy Clin Immunol 2016; 137: 1071-8.
- Klinnert MD, Nelson HS, Price MR, Adinoff AD, Leung DY, Mrazek DA. Onset and persistence of childhood asthma: predictors from infancy. Pediatrics 2001; 108: E69.
- Silverberg JI, Hanifin JM. Adult eczema prevalence and associations with asthma and other health and demographic factors: a US population-based study. J Allergy Clin Immunol 2013; 132: 1132-8.
- Ağralı N, Köse SŞ, Asilsoy S, Anal Ö. Frequency of Atopic Diseases in Immunoglobulin A Deficiency. Journal of Dr. Behcet Uz Children’s Hospital 2020;10:15-21.
- Lowe AJ, Carlin JB, Bennett CM, Hosking CS, Abramson MJ, Hill DJ, et al. Do boys do the atopic march while girls dawdle? J Allergy Clin Immunol 2008; 121: 1190-5.
- von Kobyletzki LB, Bornehag CG, Hasselgren M, Larsson M, Lindström CB, Svensson Å. Eczema in early childhood is strongly associated with the development of asthma and rhinitis in a prospective cohort. BMC Dermatol 2012; 12: 11.
- Ćosićkić A. Development of respiratory allergies, asthma and allergıc rhinits in children with atopic dermatitis. Acta Clin Croat 2017; 56: 308-17.
- Dharmage SC, Lowe AJ, Matheson MC, Burgess JA, Allen KJ, Abramson MJ. Atopic dermatitis and the atopic march revisited. Allergy 2014; 69: 17-27.
- Maciag MC, Phipatanakul W. Preventing the development of asthma stopping the allergic march. Curr Opin Allergy Clin Immunol 2019;19:161.
Abstract
Objective: Atopic march is a model that explains the progression of allergic diseases from atopic dermatitis (AD) to allergic asthma and rhinitis. In our study, while evaluating the presence of allergen sensitivity and allergic diseases in patients who were diagnosed with AD and followed up until the age of at least 5 years, we wanted to investigate how much the definition of classical atopic gait responded to expectations.
Material and Methods: We retrospectively reviewed the file records of patients diagnosed with atopic dermatitis, whose ages were 2 years and under at the time of application and followed up regularly until at least 5 years of age. We recorded the clinical and laboratory findings. We noted the allergic disease status and allergen sensitivity of the patients when they were 5 years old.
Results: Forty-one patients with a diagnosis of AD who met the criteria were identified. During the application, we found food sensitivity in 28 (68.3%) patients. When 41 patients reached the age of 5, 13 (31.7%) were diagnosed with asthma and 12 (29.2%) were diagnosed with allergic rhinitis.
Conclusion: We found the frequency of asthma and allergic rhinitis higher in patients with AD than in the normal population. However, we could not show a relationship between food sensitivity and the development of asthma and/or allergic rhinitis. Effective skin care in AD can be protective for developing of allergic diseases. In order for clinicians to understand the heterogeneity of atopic disease models in children and to eliminate this variability, infants with AD should be followed up in later life.
References
- Aksu K, Arga M, Asilsoy S Avcil S, Çetinkaya F, Civelek E, et al. Diagnosis and management of atopic dermatitis: national guideline 2018. Asthma Allergy Immunol 2018;16:1-130.
- Uysal P, Uzuner N. How is atopic dermatitis diagnosed in children? İzmir Dr. Behçet Uz Çocuk Hastanesi Dergisi 2013;3:1-11.
- Bawany F, Beck LA, Järvinen KM. Halting the march: primary prevention of atopic dermatitis and food allergies. J Allergy Clin Immunol Pract 2020;8: 860-75.
- Aw M, Penn J, Gauvreau GM, Lima H, Sehmi R. Atopic March: Collegium Internationale Allergologicum Update 2020. Int Arch Allergy Immunol 2020;181: 1-10.
- Busse WW. The atopic march: fact or folklore? Ann Allergy Asthma Immunol 2018;120:116-8.
- Rudzki E, Samochocki Z, Rebandel P, Saciuk E, Gałecki W, Raczka A, et al. Frequency and significance of the major and minor features of Hanifin and Rajka among patients with atopic dermatitis. Dermatology 1994; 189:41-6.
- Just J, Deslandes‐Boutmy E, Amat F, Desseaux K, Nemni A, Bourrat E, et al. Natural history of allergic sensitization in infants with early‐onset atopic dermatitis: results from ORCA Study. Pediatr Allergy Immunol 2014; 25:668-63.
- Bieber T, D’Erme AM, Akdis C, Traidl-Hoffmann C, Lauener R, Schäppi G, et al. Clinical phenotypes and endophenotypes of atopic dermatitis: Where are we, and where should we go? J Allergy Clin Immunol 2017; 139: 58-64.
- Tezcan I, Berkel AI, Ersoy F, Sanal O. Sağlıklı Türk çocukları ve erişkinlerde turbidometrik yöntemle bakılan serum immunoglobulin düzeyleri. Çocuk Sağlığı ve Hastalıkları Dergisi 1996; 39;649-56.
- Bantz SK, Zhu Z, Zheng T. The Atopic March: Progression from atopic dermatitis to allergic rhinitis and asthma. J Clin Cell Immunol 2014;5: 202.
- Eller E, Kjaer HF, Høst A, Andersen KE, Bindslev-Jensen C. Food allergy and food sensitization in early childhood: results from the DARC cohort. Allergy 2009; 64: 1023-9.
- Tsakok T, Marrs T, Mohsin M, Baron S, du Toit G, Till S, et al. Does atopic dermatitis cause food allergy? A systematic review. J Allergy Clin Immunol 2016; 137: 1071-8.
- Klinnert MD, Nelson HS, Price MR, Adinoff AD, Leung DY, Mrazek DA. Onset and persistence of childhood asthma: predictors from infancy. Pediatrics 2001; 108: E69.
- Silverberg JI, Hanifin JM. Adult eczema prevalence and associations with asthma and other health and demographic factors: a US population-based study. J Allergy Clin Immunol 2013; 132: 1132-8.
- Ağralı N, Köse SŞ, Asilsoy S, Anal Ö. Frequency of Atopic Diseases in Immunoglobulin A Deficiency. Journal of Dr. Behcet Uz Children’s Hospital 2020;10:15-21.
- Lowe AJ, Carlin JB, Bennett CM, Hosking CS, Abramson MJ, Hill DJ, et al. Do boys do the atopic march while girls dawdle? J Allergy Clin Immunol 2008; 121: 1190-5.
- von Kobyletzki LB, Bornehag CG, Hasselgren M, Larsson M, Lindström CB, Svensson Å. Eczema in early childhood is strongly associated with the development of asthma and rhinitis in a prospective cohort. BMC Dermatol 2012; 12: 11.
- Ćosićkić A. Development of respiratory allergies, asthma and allergıc rhinits in children with atopic dermatitis. Acta Clin Croat 2017; 56: 308-17.
- Dharmage SC, Lowe AJ, Matheson MC, Burgess JA, Allen KJ, Abramson MJ. Atopic dermatitis and the atopic march revisited. Allergy 2014; 69: 17-27.
- Maciag MC, Phipatanakul W. Preventing the development of asthma stopping the allergic march. Curr Opin Allergy Clin Immunol 2019;19:161.
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | ORIGINAL ARTICLES |
| Authors | |
| Publication Date | September 20, 2022 |
| Submission Date | September 10, 2021 |
| Published in Issue | Year 2022 Volume: 16 Issue: 5 |
The publication language of Turkish Journal of Pediatric Disease is English.
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