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House dust mite sensitization in toddlers predicts current wheeze at age 12 years



House dust mite sensitization in toddlers predicts current wheeze at age 12 years

Caroline J. Lodge, MBBS, GradDipEpi, Adrian J. Lowe, BBSc, MPH, PhD, Lyle C. Gurrin, BSc(Hons), PhD, David J. Hill, MBBS, FRACP, Clifford S. Hosking, MD, FRACP, FRACPA, Rida U. Khalafzai, MBBS, MPH, John L. Hopper, BA, BSc, MSc, PhD, Melanie C. Matheson, BSc, MAppSc, PhD, Michael J. Abramson, MBBS, BMedSc(Hons), PhD, FRACP, FAFPHM, Katrina J. Allen, MBBS, BMedSc, FRACP, PhD, Shyamali C. Dharmage, MBBS, MSc, MD, PhD

The Journal of Allergy and Clinical Immunology,
128:4, August 08, 2011

House dust mite sensitization in toddlers predicts current wheeze at age 12 years

Objective
We sought to determine whether skin prick tests (SPTs) to individual allergens up to age 2 years predict wheeze at age 12 years.


Methods
In a birth cohort of 620 children oversampled for familial allergy, sensitization was assessed by using SPTs (monosensitized, polysensitized, or either) to 6 allergens at ages 6, 12, and 24 months. Wheeze and eczema were recorded 18 times during the first 2 years. Current wheeze was recorded at age 12 years. Adjusted associations were evaluated by multiple logistic regression.


Results
A positive SPT to house dust mite (HDM) at age 1 or 2 years predicted wheeze at age 12 years (adjusted odds ratio: 1 year, 3.31 [95% CI 1.59-6.91]; 2 years, 6.37 [95% CI, 3.48-11.66]). Among wheezy 1-year-olds, those who were HDM sensitized had a 75% (95% CI, 51% to 91%) probability of wheeze at age 12 years compared with a 36% (95% CI, 23% to 50%) probability among those not sensitized. Among eczematous 1-year-olds, those who were HDM sensitized had a 67% (95% CI, 45% to 84%) probability of wheeze at age 12 years compared with a 35% (95% CI, 25% to 45%) probability among those not sensitized. Among 1-year-old children with both eczema and wheeze, the probability of wheeze at age 12 years was 64% (95% CI, 35% to 87%) if HDM sensitized and 50% (95% CI, 26% to 74%) if not.


Conclusion
HDM sensitization at age 1 or 2 years in wheezing and eczematous children at increased familial allergy risk predicts asthma and may inform management of these high-risk groups.







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Prepared by: Dr. Houssam Al-Nahhas






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