Research Article
Open Access
Epidemiology of Asthma in 94 Children with Atopic
Dermatitis
Arnaldo Cantani*
Allergy and Immunology Division, Department of Pediatrics, University of Rome La Sapienza, Italy
*Corresponding author: Arnaldo Cantani, Allergy and Immunology Division, Department of Pediatrics, University of Rome La Sapienza, Via
Baglivi 7, I 00161 Roma, Italy, Fax: +0039-0644230256; E-mail:
@
Received: February 19, 2015; Accepted: April 23, 2015; Published: April 30, 2015
Citation: Cantani A (2015) Epidemiology of Asthma in 94 Children with Atopic Dermatitis. J Nutrition Health Food Sci 3(2):
1-2. DOI: http://dx.doi.org/10.15226/jnhfs.2015.00143
AbstractTop
In this paper we present 94 children affected with Atopic
Dermatitis (AD), aggravated by respiratory allergy, asthma and/
or Allergic Rhinitis (AR). AD is a common disorder, frequently
complicated by asthma-like symptoms, we debate either disorder
and concluded that both AR and asthma can afflict most babies with
AD, especially when both parents smoke. We confirm our previous
statistics, according to which little children not fed breast milk may
react to smallest doses of allergens.
Keywords: Asthma; Atopic dermatitis; Allergic rhinitis; Cow milk
Keywords: Asthma; Atopic dermatitis; Allergic rhinitis; Cow milk
Introduction
Atopic Dermatitis (AD) has a clinical pattern which often
manifests itself in association with a personal and/or family
history of atopic respiratory disorders such as asthma or allergic
rhinitis. AD is characterized by a clinical pattern dominated by
eczematic skin lesion and itching, which provokes an unremitting
scratching, aggravating the lesions and is frequently associated
with asthma and/or AR [1-5].
Materials and Methods
Among 855 children extracted from the card-file of AD by chance
(with the aleatory numbers) we selected 94 babies of either sex
aged 3-6 years affected with both AD and asthma and/or AR, all
children less two were fed maternal milk for 1- 6 months (median
4,5), after which they were weaned Cow’s Milk (CM) diluted with
water. The first CM weaning precipitated the symptoms, such as
vomiting and diarrhea and the babies were mostly fed soy milk.
Appropriate emergency equipment and medications were
available on site. All possible drugs were stopped at least 2
weeks before the application of the SPTs. Ninety three healthy
babies of the same age and sex with the permission of their
parents were the controls. SPTs were done at baseline by the
prick method on the volar surface of the forearm by myself
with the co-operation of a qualified nurse. The skin was marked
with a ballpoint pen for the allergens to be tested. The babies
were then tested with: histamine hydrochloride (1mg/ml) as
a positive control and isotonic saline as a negative control. We
continued with a battery of food allergens, including whole CM
protein, beta-lactoglobulin, casein, lactalbumin and a battery of inhalant allergens, including house dust mite pollen, dust, dust
mite, mold, animal dander (Lofarma). The diagnostic extract
of each individual allergen was placed on the volar surface of
the forearm as drops through which the skin was superficially
pricked with a straight pin for one second. A new pin was used
for each SPT and then discarded, and the drop of the extract was
then wiped off about one minute after the prick.
SPT reading
SPTs were read 20 minutes after the test was finished and
considered positive as follows:
+ when the wheal was the half of the histamine wheal;
++ when the wheal was equal to the histamine wheal;
+++ when the wheal was two-fold the histamine wheal;
++++ when the wheal was more than two-fold the histamine wheal.
We took for positive only children with a +++ or ++++ reaction, that is a wheal = 3 mm with an area = 7 mm2 (cut-off). So we considered as positive only the children with a mean wheal diameter of 3 mm or larger than the negative (saline) control. A positive (histamine) control was performed to ensure the absence of any antihistamine drug interference.
+ when the wheal was the half of the histamine wheal;
++ when the wheal was equal to the histamine wheal;
+++ when the wheal was two-fold the histamine wheal;
++++ when the wheal was more than two-fold the histamine wheal.
We took for positive only children with a +++ or ++++ reaction, that is a wheal = 3 mm with an area = 7 mm2 (cut-off). So we considered as positive only the children with a mean wheal diameter of 3 mm or larger than the negative (saline) control. A positive (histamine) control was performed to ensure the absence of any antihistamine drug interference.
Statistical analysis
The statistical analysis was performed using the X2
test. Results with a p < 0.05 were considered as statistically
significant. At the CM reintroduction, for diagnostic purposes, all
babies presented again with diarrhea, one with a short state of
shock promptly regressed after immediate parenteral treatment.
The 94 healthy controls, similar for sex and age had no clinical
reactions by eating whatever food.
Results
All 94 babies suffered from either respiratory or food
allergy. Among them 23 (24.9%) were affected by both AD
and respiratory allergy. Of these 23, 13 children, 7 males and
6 females, aged between 2 and 6 years, median 3, showed a
positive Food Provocation Test (FPT) and in the remaining 10 negative, 6 males and 4 females aged between 2 and 9 years,
median 5.5 the test was negative. We stress that some children
reacted to very small doses of allergens: 14 asthmatic children
fed foods reacted with wheezing. Therefore, I recommend that
in FPTs, medical doctors with resuscitation equipment are
present on the scene since the first moment. It is of note that the
statistical analysis had a highly significant difference with SPTs
(p=0.013). However, 80/94 children (85.1%) had SPTs done and
only 46 the RAST.
Discussion
An important result is suggested by Nwaru et al. [6]:
Allergic sensitization to any food allergen was associated with
late introduction of potatoes (4 months), oats (5.5 months),
rye (7 months), meat (5.5 months), fish (8.2 months), and eggs
(10.5 months) who studied 994 children. The median duration
of exclusive breastfeeding in the whole study population was
1.8 months (range: 0.0 –10.0 months). In this study breastfeeding
was continued for 1- 6 months however we have calculated
the median 4.5), which gives a high duration of breastfeeding.
We suggest that a longer duration of breast feeding, as in the
present study may have protected the children by Nwaru et al. [6]
AD complicated by asthma and or AR is a severe disease, which
poses in the first place the house dust controls. The children in
this study were protected from cigarette smoke since beginning.
The study by Nwaru et al. [6] says that mothers failed to smoke only during pregnancy and the children must be prevented from wheezing, a severe disease [7,8].
The study by Nwaru et al. [6] says that mothers failed to smoke only during pregnancy and the children must be prevented from wheezing, a severe disease [7,8].
ReferencesTop
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