학령전기 만성 기침 환아에서 알레르기 감작의 위험 요인
Risk factors of allergic sensitization in preschool children with chronic cough
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Purpose: Chronic cough is one of the major symptoms of asthma and allergic sensitization and may appear prior to the onset of asthma. The object of this study was to investigate the risk of allergic sensitization in preschool children with chronic cough. Methods: We reviewed the medical records of 99 preschool children presenting with chronic cough but not with allergic rhinitis, atopic dermatitis, recurrent wheezing, or lower respiratory tract infection between November 2011 and July 2013. Results: Fifty-four children (55%) were sensitized at least one of the following inhalant allergens: Dermatophagoides pteronyssinus, Dermatophagoides farinae, cockroach, Alternaria alternata, dog dander, and cat epithelium. Children with allergic sensitization had a higher blood total IgE levels transformed by common logarithm (1.9±0.6 IU/mL vs. 1.3±0.5 IU/mL, P<0.001) and eosinophils (3.7%±2.5% vs. 2.7%±2.0%, P=0.043), more frequent parental history of allergy (68% vs. 48%, P=0.044) and less frequent history of breast milk feeding (68% vs. 86%, P=0.041) than those without. Conclusion: These results suggest that the ratio of allergic sensitization may be 50% or more in preschool children with chronic cough and that parental history of allergy and formula milk feeding may be associated with allergic sensitization.
Abstract
Purpose: Chronic cough is one of the major symptoms of asthma and allergic sensitization and may appear prior to the onset of asthma. The object of this study was to investigate the risk of allergic sensitization in preschool children with chronic cough. Methods: We reviewed the medical records of 99 preschool children presenting with chronic cough but not with allergic rhinitis, atopic dermatitis, recurrent wheezing, or lower respiratory tract infection between November 2011 and July 2013. Results: Fifty-four children (55%) were sensitized at least one of the following inhalant allergens: Dermatophagoides pteronyssinus, Dermatophagoides farinae, cockroach, Alternaria alternata, dog dander, and cat epithelium. Children with allergic sensitization had a higher blood total IgE levels transformed by common logarithm (1.9±0.6 IU/mL vs. 1.3±0.5 IU/mL, P<0.001) and eosinophils (3.7%±2.5% vs. 2.7%±2.0%, P=0.043), more frequent parental history of allergy (68% vs. 48%, P=0.044) and less frequent history of breast milk feeding (68% vs. 86%, P=0.041) than those without. Conclusion: These results suggest that the ratio of allergic sensitization may be 50% or more in preschool children with chronic cough and that parental history of allergy and formula milk feeding may be associated with allergic sensitization.
참고문헌 (21)
- Munyard P, "How much coughing is normal?", Arch Dis Child, 74, pp.531~534 (1996)
- Newson T, "Cough and asthma in children", Pediatr Ann, 25, pp.156~158 (1996)
- Goldsobel AB, "The adult with chronic cough", J Allergy Clin Immunol, 130, pp.825~825.e6 (2012)
- Chang AB, "A cough algorithm for chronic cough in children: a multicenter, randomized controlled study", Pediatrics, 131, pp.e1576~e1583 (2013)
- 이주경, "학령 전기 기침이형천식 환자에서의 전형적인 천식 증상 발생과 기관지 과민성의 연관성", Allergy Asthma & Respiratory Diseases, 22(4), pp.364~373 (2012), 대한 소아알레르기 호흡기학회
- Guilbert TW, "Atopic characteristics of children with recurrent wheezing at high risk for the development of childhood asthma", J Allergy Clin Immunol, 114, pp.1282~1287 (2004)
- Hannaway PJ, "Cough variant asthma in children", JAMA, 247, pp.206~208 (1982)
- Weinberger M, "Differential diagnosis of chronic cough in children", Allergy Asthma Proc, 35, pp.95~103 (2014)
- Chang AB, "A multicenter study on chronic cough in children : burden and etiologies based on a standardized management pathway", Chest, 142, pp.943~950 (2012)
- Asilsoy S, "Evaluation of chronic cough in children", Chest, 134, pp.1122~1128 (2008)
- Khoshoo V, "Associated factors in children with chronic cough", Chest, 136, pp.811~815 (2009)
- Marchant JM, "Evaluation and outcome of young children with chronic cough", Chest, 129, pp.1132~1141 (2006)
- van der Heide S, "Allergy to mites: relation to lung function and airway hyperresponsiveness", Allergy, 53(48 Suppl), pp.104~107 (1998)
- Drkulec V, "Sensitization profile in differential diagnosis: allergic asthma vs. chronic (nonspecific)cough syndrome", Med Sci Monit, 19, pp.409~415 (2013)
- Wagner JB, "Chronic cough in children", Pediatr Clin North Am, 60, pp.951~967 (2013)
- Chang AB, "Guidelines for evaluating chronic cough in pediatrics:ACCP evidence-based clinical practice guidelines", Chest, 129(1 Suppl), pp.260S~283S (2006)
- 김영휘, "2009년 학동 전기 소아에서 알레르기질환의 유병률과 위험인자", Allergy Asthma & Respiratory Diseases, 21(3), pp.165~175 (2011), 대한 소아알레르기 호흡기학회
- 정진아, "5세 미만의 기침이형천식 소아에서 흡입용 스테로이드와류코트리엔 수용체 길항제의 치료 효과", Allergy Asthma & Respiratory Diseases, 15(3), pp.263~269 (2005), 대한 소아알레르기 호흡기학회
- Shields MD, "BTS guidelines: recommendations for the assessment and management of cough in children", Thorax, 63(Suppl 3), pp.iii1~iii15 (2008)
- Shields MD, "Chronic cough in children", Paediatr Respir Rev, 14, pp.100~105 (2013)
- Wilson NW, "Sinusitis and chronic cough in children", J Asthma Allergy, 5, pp.27~32 (2012)