Asia Pac Allergy.  2015 Apr;5(2):78-83. 10.5415/apallergy.2015.5.2.78.

Clinical manifestation and sensitization of allergic children from Malaysia

• Yadav A
• Naidu R

• KMID: 2397054
• DOI: http://doi.org/10.5415/apallergy.2015.5.2.78

Abstract

BACKGROUND
An epidemiological rise of allergic diseases in developing countries raises new challenges. Currently a paucity of data exists describing allergy symptomology and sensitization to common food and aeroallergens in young children from developing countries.
OBJECTIVE
To compare changes in symptomology, food allergen sensitization and aeroallergen sensitization in a cross-sectional study of children < 2 years and 2-10 years.
METHODS
A total of 192 allergic children (aged < 2 years, 35 children; aged 2-10 years, 157 children) underwent specific IgE (>0.35 kU/L) to common food (egg white, cow's milk, cod fish, wheat, peanut, soya, peanut, and shrimp) and house dust mites (Dermatophagoides pteronyssinus and Blomia tropicalis).
RESULTS
In children < 2 years, atopic dermatitis (65.7%) was the most common symptom whereas in children 2-10 years it was rhinoconjunctivitis (74.5%). Higher sensitization rate to eggs (p < 0.01) and cow's milk (p = 0.044) was seen in < 2 years group when compared to the 2-10 years group, but no significant differences for shrimp (p = 0.29), wheat (p = 0.23) and soya (p = 0.057). Interestingly, sensitization to peanut (p = 0.012) and fish (p = 0.035) was significantly decreased in the 2-10 years group. Sensitization to house dust mites (p < 0.01) dramatically increased in the older children.
CONCLUSION
Our study supports concept of atopic march from a developing country like Malaysia.

Keyword

Hypersensitivity; Allergens; Asia; Food; Pyroglyphidae

MeSH Terms

Allergens
Arachis
Asia
Child*
Cross-Sectional Studies
Dermatitis, Atopic
Developing Countries
Eggs
Humans
Hypersensitivity
Immunoglobulin E
Malaysia*
Milk
Ovum
Pyroglyphidae
Triticum
Allergens
Immunoglobulin E

Reference

1. Williams H, Stewart A, von Mutius E, Cookson W, Anderson HR;. ISAAC) Phase One and Three Study Groups. Is eczema really on the increase worldwide? J Allergy Clin Immunol. 2008; 121:947–954.e15.

2. Chiang WC, Kidon MI, Liew WK, Goh A, Tang JP, Chay OM. The changing face of food hypersensitivity in an Asian community. Clin Exp Allergy. 2007; 37:1055–1061.

3. Leung TF, Lam CW, Chan IH, Li AM, Tang NL. Sensitization to common food allergens is a risk factor for asthma in young Chinese children in Hong Kong. J Asthma. 2002; 39:523–529.

4. Kulig M, Bergmann R, Klettke U, Wahn V, Tacke U, Wahn U. Natural course of sensitization to food and inhalant allergens during the first 6 years of life. J Allergy Clin Immunol. 1999; 103:1173–1179.

5. Kijima A, Murota H, Takahashi A, Arase N, Yang L, Nishioka M, Yamaoka T, Kitaba S, Yamauchi-Takihara K, Katayama I. Prevalence and impact of past history of food allergy in atopic dermatitis. Allergol Int. 2013; 62:105–112.

6. Ohshima Y, Yamada A, Hiraoka M, Katamura K, Ito S, Hirao T, Akutagawa H, Kondo N, Morikawa A, Mayumi M. Early sensitization to house dust mite is a major risk factor for subsequent development of bronchial asthma in Japanese infants with atopic dermatitis: results of a 4-year followup study. Ann Allergy Asthma Immunol. 2002; 89:265–270.

7. Leung R, Ho P, Lam CW, Lai CK. Sensitization to inhaled allergens as a risk factor for asthma and allergic diseases in Chinese population. J Allergy Clin Immunol. 1997; 99:594–599.

8. Boye JI. Food allergies in developing and emerging economies: need for comprehensive data on prevalence rates. Clin Transl Allergy. 2012; 2:25.

9. Tan TN, Lim DL, Lee BW, Van Bever HP. Prevalence of allergy-related symptoms in Singaporean children in the second year of life. Pediatr Allergy Immunol. 2005; 16:151–156.

10. Chiang WC, Chen YM, Tan HK, Balakrishnan A, Liew WK, Lim HH, Goh SH, Loh WY, Wong P, Teoh OH, Goh A, Chay OM. Allergic rhinitis and non-allergic rhinitis in children in the tropics: prevalence and risk associations. Pediatr Pulmonol. 2012; 47:1026–1033.

11. Kapoor R, Menon C, Hoffstad O, Bilker W, Leclerc P, Margolis DJ. The prevalence of atopic triad in children with physician-confirmed atopic dermatitis. J Am Acad Dermatol. 2008; 58:68–73.

12. Chung Y, Kwon JH, Kim J, Han Y, Lee SI, Ahn K. Retrospective analysis of the natural history of atopic dermatitis occurring in the first year of life in Korean children. J Korean Med Sci. 2012; 27:723–728.

13. Eigenmann PA, Sicherer SH, Borkowski TA, Cohen BA, Sampson HA. Prevalence of IgE-mediated food allergy among children with atopic dermatitis. Pediatrics. 1998; 101:E8.

14. Hill DJ, Hosking CS, Zhie CY, Leung R, Baratwidjaja K, Iikura Y, Iyngkaran N, Gonzalez-Andaya A, Wah LB, Hsieh KH. The frequency of food allergy in Australia and Asia. Environ Toxicol Pharmacol. 1997; 4:101–110.

15. Boyce JA, Assa'ad A, Burks AW, Jones SM, Sampson HA, Wood RA, Plaut M, Cooper SF, Fenton MJ, Arshad SH, Bahna SL, Beck LA, Byrd-Bredbenner C, Camargo CA Jr, Eichenfield L, Furuta GT, Hanifin JM, Jones C, Kraft M, Levy BD, Lieberman P, Luccioli S, McCall KM, Schneider LC, Simon RA, Simons FE, Teach SJ, Yawn BP, Schwaninger JM. NIAID-Sponsored Expert Panel. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. J Allergy Clin Immunol. 2010; 126:1105–1118.

16. Keet CA, Matsui EC, Dhillon G, Lenehan P, Paterakis M, Wood RA. The natural history of wheat allergy. Ann Allergy Asthma Immunol. 2009; 102:410–415.

17. Mansouri M, Pourpak Z, Mozafari H, Abdollah Gorji F, Shokouhi Shoormasti R. Follow-up of the wheat allergy in children; consequences and outgrowing the allergy. Iran J Allergy Asthma Immunol. 2012; 11:157–163.

18. Kotaniemi-Syrjanen A, Palosuo K, Jartti T, Kuitunen M, Pelkonen AS, Makela MJ. The prognosis of wheat hypersensitivity in children. Pediatr Allergy Immunol. 2010; 21(2 Pt 2):e421–e428.

19. Savage JH, Kaeding AJ, Matsui EC, Wood RA. The natural history of soy allergy. J Allergy Clin Immunol. 2010; 125:683–686.

20. Lim DL, Neo KH, Yi FC, Chua KY, Goh DL, Shek LP, Giam YC, Van Bever HP, Lee BW. Parvalbumin: the major tropical fish allergen. Pediatr Allergy Immunol. 2008; 19:399–407.

21. Nafstad P, Nystad W, Magnus P, Jaakkola JJ. Asthma and allergic rhinitis at 4 years of age in relation to fish consumption in infancy. J Asthma. 2003; 40:343–348.

22. Kiefte-de Jong JC, de Vries JH, Franco OH, Jaddoe VW, Hofman A, Raat H, de Jongste JC, Moll HA. Fish consumption in infancy and asthma-like symptoms at preschool age. Pediatrics. 2012; 130:1060–1068.

23. Kull I, Bergstrom A, Lilja G, Pershagen G, Wickman M. Fish consumption during the first year of life and development of allergic diseases during childhood. Allergy. 2006; 61:1009–1015.

24. Connett GJ, Gerez I, Cabrera-Morales EA, Yuenyongviwat A, Ngamphaiboon J, Chatchatee P, Sangsupawanich P, Soh SE, Yap GC, Shek LP, Lee BW. A population-based study of fish allergy in the Philippines, Singapore and Thailand. Int Arch Allergy Immunol. 2012; 159:384–390.

25. Lee AJ, Thalayasingam M, Lee BW. Food allergy in Asia: how does it compare? Asia Pac Allergy. 2013; 3:3–14.

26. Shek LP, Cabrera-Morales EA, Soh SE, Gerez I, Ng PZ, Yi FC, Ma S, Lee BW. A population-based questionnaire survey on the prevalence of peanut, tree nut, and shellfish allergy in 2 Asian populations. J Allergy Clin Immunol. 2010; 126:324–331. 331.e1–331.e7.

27. Chiang WC, Pons L, Kidon MI, Liew WK, Goh A, Wesley Burks A. Serological and clinical characteristics of children with peanut sensitization in an Asian community. Pediatr Allergy Immunol. 2010; 21(2 Pt 2):e429–e438.

28. Gendeh BS, Mujahid SH, Murad S, Rizal M. Atopic sensitization of children with rhinitis in Malaysia. Med J Malaysia. 2004; 59:522–529.

29. Mariana A, Ho TM, Sofian-Azirun M, Wong AL. House dust mite fauna in the Klang Valley, Malaysia. Southeast Asian J Trop Med Public Health. 2000; 31:712–721.