단일 기관에서 경험한 소아 아토피피부염 환자의 감작 분포
Sensitization in children with atopic dermatitis: a single center study
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Purpose: There are few recent data regarding allergic sensitization of atopic dermatitis (AD) in Korea. The aim of this study was to investigate patterns of sensitization according to age and gender in children with AD. Methods: This retrospective study included 4,661 children with AD from 1998 to 2014. The serum specific IgE (sIgE) levels to egg white (EW), cow’s milk (CM), peanut, wheat, soybean, buckwheat, tree nuts, crustaceans, meat, and house dust mites (HDMs) were reviewed. AD was categorized into the extrinsic (ADe) and intrinsic type (ADi) according to the presence or absence of sensitization. The proportion of patients with sIgE to EW or CM greater than the previously reported diagnostic decision point (DDP) was determined. Results: A total of 4,661 children (2,843 boys and 1,818 girls) were collected. We identified 1,857 of 2,663 children (69.7%) with the ADe type and 806 of 2,663 children (30.3%) with the ADi type. The sensitization rates increased with age (P<0.001). EW (59.3%) was the most commonly sensitized food, followed by CM (46.6%), peanut (32.2%), wheat (31.5%), soybean (28.1%), and buckwheat (23.7%). The most commonly sensitized food groups were tree nuts (56.7%) and crustaceans (28.3%). The rate of sensitization to HDMs was 40.1%. In addition, 11.1% and 7.5% of children had levels of sIgE to EW and CM, respectively, higher than the DDP. Conclusion: The incidence of ADe among children with AD was 69.7% and increased with age. The most commonly sensitized food allergen was EW, followed by CM and peanut.
Abstract
Purpose: There are few recent data regarding allergic sensitization of atopic dermatitis (AD) in Korea. The aim of this study was to investigate patterns of sensitization according to age and gender in children with AD. Methods: This retrospective study included 4,661 children with AD from 1998 to 2014. The serum specific IgE (sIgE) levels to egg white (EW), cow’s milk (CM), peanut, wheat, soybean, buckwheat, tree nuts, crustaceans, meat, and house dust mites (HDMs) were reviewed. AD was categorized into the extrinsic (ADe) and intrinsic type (ADi) according to the presence or absence of sensitization. The proportion of patients with sIgE to EW or CM greater than the previously reported diagnostic decision point (DDP) was determined. Results: A total of 4,661 children (2,843 boys and 1,818 girls) were collected. We identified 1,857 of 2,663 children (69.7%) with the ADe type and 806 of 2,663 children (30.3%) with the ADi type. The sensitization rates increased with age (P<0.001). EW (59.3%) was the most commonly sensitized food, followed by CM (46.6%), peanut (32.2%), wheat (31.5%), soybean (28.1%), and buckwheat (23.7%). The most commonly sensitized food groups were tree nuts (56.7%) and crustaceans (28.3%). The rate of sensitization to HDMs was 40.1%. In addition, 11.1% and 7.5% of children had levels of sIgE to EW and CM, respectively, higher than the DDP. Conclusion: The incidence of ADe among children with AD was 69.7% and increased with age. The most commonly sensitized food allergen was EW, followed by CM and peanut.
참고문헌 (33)
- Akdis CA, "Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology", American Academy of Allergy, Asthma and Immunology, Allergy, pp.2006, 61[DOI]
- 안강모, "2010년 한국 어린이·청소년의 천식, 알레르기 비결막염, 아토피피부염 증상 유병률 조사: 복합표본설계를 이용한 전국 서베이", 대한의사협회지, 54(7), pp.769~778 (2011), 대한의사협회
- Ricci G, "Atopic dermatitis: quality of life of young Italian children and their families and correlation with severity score", Pediatr Allergy Immunol, 18, pp.245~249 (2007)
- Lee SI, "A proposal: atopic dermatitis organizer (ADO) guideline for children", Asia Pac Allergy, 1, pp.53~63 (2011)
- Schneider L, "Atopic dermatitis: a practice parameter update 2012", J Allergy Clin Immunol, 131, pp.295~299 (2013)
- Leung DY, "Deciphering the complexities of atopic dermatitis: shifting paradigms in treatment approaches", J Allergy Clin Immunol, 134, pp.769~779 (2014)
- Pugliarello S, "Phenotypes of atopic dermatitis", J Dtsch Dermatol Ges, 9, pp.12~20 (2011)
- Tokura Y, "Extrinsic and intrinsic types of atopic dermatitis", J Dermatol Sci, 58, pp.1~7 (2010)
- 김형수, "소아에서 IgE 매개성과 비 IgE 매개성 아토피피부염의 특징", Allergy Asthma & Respiratory Diseases, 1(4), pp.339~343 (2013), 대한 소아알레르기 호흡기학회
- Park JH, "Characteristics of extrinsic vs. intrinsic atopic dermatitis in infancy: correlations with laboratory variables", Br J Dermatol, 155, pp.778~783 (2006)
- 나혜연, "2세 이하 영유아 중증 아토피피부염에서의 항원 감작", Allergy Asthma & Respiratory Diseases, 19(2), pp.146~154 (2009), 대한 소아알레르기 호흡기학회
- 이주석, "IgE 매개성, 비 IgE 매개성 소아 아토피피부염 환아의분류에 관한 연구", Allergy Asthma & Respiratory Diseases, 15(4), pp.352~358 (2005), 대한 소아알레르기 호흡기학회
- Sicherer SH, "Food allergy: epidemiology, pathogenesis, diagnosis, and treatment", J Allergy Clin Immunol, 133, pp.291~307 (2014)
- 송태원, "식품 경구유발시험 가이드라인", Allergy Asthma & Respiratory Diseases, 22(1), pp.4~20 (2012), 대한 소아알레르기 호흡기학회[DOI]
- 송태원, "Diagnostic Decision Points of Specific IgE Titers in Patients With Food Allergy: Are They Appropriate in All Clinical Settings?", Allergy, Asthma & Immunology Research, 7(4), pp.309~311 (2015), 대한천식알레르기학회
- Sampson HA, "Relationship between food-specific IgE concentrations and the risk of positive food challenges in children and adolescents", J Allergy Clin Immunol, 100, pp.444~451 (1997)
- 한영신, "아토피피부염 환아의 식품 알레르겐에 대한 감작률 분석을 통한 식품 알레르기의 고찰", 대한지역사회영양학회지, 9(1), pp.90~97 (2004), 대한지역사회영양학회
- 한동기, "Food Sensitization in Infants and Young Children with Atopic Dermatitis", Yonsei Medical Journal, 45(5), pp.803~809 (2004), 연세대학교의과대학
- Hanifin JM, "Diagnostic features of atopic dermatitis", Acta Derm Venereol (Stockh), 92, pp.44~47 (1980)
- "Severity scoring of atopic dermatitis: the SCORAD index. Consensus report of the European task force on atopic dermatitis", Dermatology, 186, pp.23~31 (1993)
- 박미란, "아토피피부염을 가진 24개월 미만의 소아에서 집먼지진드기 특이 IgE 항체의 양전", Allergy Asthma & Respiratory Diseases, 1(4), pp.350~356 (2013), 대한 소아알레르기 호흡기학회
- Schäfer T, "Association between severity of atopic eczema and degree of sensitization to aeroallergens in schoolchildren", J Allergy Clin Immunol, 104, pp.1280~1284 (1999)
- 김지현, "Diagnostic Decision Points of Specific IgE Concentrations in Korean Children With Egg and Cow’s Milk Allergies", Allergy, Asthma & Immunology Research, 7(4), pp.332~338 (2015), 대한천식알레르기학회
- Wüthrich B, "The atopic eczema", dermatitis syndrome. Epidemiology, natural course, and immunology of the IgE-associated ("extrinsic") and the nonallergic ("intrinsic") AEDS, 2003, pp.13, 1~5
- Rho NK, "Immunophenotyping of inflammatory cells in lesional skin of the extrinsic and intrinsic types of atopic dermatitis", Br J Dermatol, 151, pp.119~125 (2004)
- Suk-JinChoi, "Comparison of Transepidermal Water Loss, Capacitance and pH Values in the Skin between Intrinsic and Extrinsic Atopic Dermatitis Patients", Journal of Korean Medical Science, 18(1), pp.93~96 (2003), 대한의학회
- Ott H, "Total serum IgE as a parameter to differentiate between intrinsic and extrinsic atopic dermatitis in children", Acta Derm Venereol, 89, pp.257~261 (2009)
- Novembre E, "Natural history of "intrinsic" atopic dermatitis", Allergy, 56, pp.452~453 (2001)
- Baatenburg de Jong A, "High prevalence of sensitization to aeroallergens in children 4 yrs of age or younger with symptoms of allergic disease", Pediatr Allergy Immunol, 20, pp.735~740 (2009)
- Wang IJ, "Correlation between age and allergens in pediatric atopic dermatitis", Ann Allergy Asthma Immunol, 93, pp.334~338 (2004)
- Kulig M, "Natural course of sensitization to food and inhalant allergens during the first 6 years of life", J Allergy Clin Immunol, 103, pp.1173~1179 (1999)
- 조규랑, "2002년과 2007년 부산 지역 1개 대학병원에 내원한 소아 아토피피부염 환자의 우유, 난백, 대두에 대한 감작률의 비교", Allergy Asthma & Respiratory Diseases, 18(4), pp.283~291 (2008), 대한 소아알레르기 호흡기학회
- Fleischer DM, "The natural history of peanut and tree nut allergy", Curr Allergy Asthma Rep, 7, pp.175~181 (2007)