Positive conversion of specific IgE against house dust mite in children with atopic dermatitis under 24 months of age

Miran Park; Hyun Young Lee; Sang-Il Lee; Jihyun Kim; Kangmo Ahn

doi:10.4168/aard.2013.1.4.350

Journal List > Allergy Asthma Respir Dis > v.1(4) > 1058984

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Park, Lee, Lee, Kim, and Ahn: Positive conversion of specific IgE against house dust mite in children with atopic dermatitis under 24 months of age

Original Article

Allergy, Asthma & Respiratory Disease 2013; 1(4): 350-356.

Published online: 31 December 2013

DOI: https://doi.org/10.4168/aard.2013.1.4.350

Positive conversion of specific IgE against house dust mite in children with atopic dermatitis under 24 months of age

Miran Park^1,², Hyun Young Lee¹, Sang-Il Lee^1,², Jihyun Kim^1,², Kangmo Ahn^1,²

¹Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

²Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea.

Correspondence to: Kangmo Ahn. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. Tel: +82-2-3410-3539, Fax: +82-2-3410-0043, kmaped@skku.edu

Received 26 June 2013 Revised 29 September 2013 Accepted 30 September 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

Abstract

Purpose

A considerable number of children with atopic dermatitis (AD) is known to be sensitized with respiratory allergen and developed to respiratory allergic disease. We aimed to determine the time of sensitization to house dust mite (HDM) allergen and identify the risk factors of sensitization in children with AD.

Methods

Data from 159 children with AD aged less than 24 months and with no sensitization to HDM were analyzed retrospectively. Disease severity, total IgE, specific IgE levels to HDM and food allergens were assessed. They were followed to monitor positive conversion of specific IgE against HDM and development of allergic respiratory diseases. The specific IgE was considered as positive when its level was over 0.69 kU/L.

Results

The 44.7% of children with AD were sensitized to HDM. The 50% of sensitization to HDM occurred at the median age of 52 months using survival analysis. The severity of atopic dermatitis (six area, six sign in atopic dermatitis score>15; hazard ratio, 2.62) and high peak total IgE in 2 years old (hazard ratio, 1.58) was associated with an increased risk of sensitization to HDM. Sensitization to food allergen, family history of allergic disease and total IgE of 1st visit of hospital were not associated with early sensitization to HDM.

Conclusion

The sensitization of HDM of children with AD occurred at the median age of 52 months. The risk factors of sensitization to HDM were AD severity and total IgE level. Children with severe AD need to control the indoor environment before 24 months of age.

Keywords: Atopic dermatitis, House dust mites, Immunologic sensitization

Figures and Tables

Fig. 1

The development of sensitization to house dust mite.

Fig. 2

The comparison of sensitization to house dust mite according to atopic dermatitis (AD) severity score. The Kaplan-Meier survival curve shows that children with moderate to severe AD (SASSAD≥15) were sensitized to house dust mite earlier than children with mild AD (SASSAD<15). SASSAD, six area six sign in atopic dermatitis.

Table 1

General characteristics of the subjects (n=159)

Values are presented as mean (range).

AD, atopic dermatitis; SASSAD, six area six sign in atopic dermatitis.

Table 2

Factors affecting sensitization to house dust mite by log-rank test

HDM, house dust mite; CI, confidence interval; AD, atopic dermatitis; SASSAD, six area six sign in atopic dermatitis.

Table 3

Predictors of house dust mite sensitization by univariate analysis using Cox proportional hazard model

CI, confidence interval.

Peak: highest value before 24 months of age.

^*Logarithm.

Table 4

Predictors of house dust mite sensitization by multivariate analysis

CI, confidence interval; SASSAD, six area six sign in atopic dermatitis.

Notes

This study was funded by Environmental Health Research Center Project by the Ministry of Environment, Korea.

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