Alternaria Sensitization and Allergy in Children and Adolescents: A Retrospective Diagnostic Study

Le résumé fourni par la source

Purpose: Alternaria alternata (AA) grows on decaying material. Spores occur on hot and dry days in the summer and can trigger asthma and allergic rhinitis. Skin prick test (SPT-AA) and Alternaria alternata -specific IgE (AA-IgE) are used for diagnostic purposes, but their predictive value is unclear. Patients and Methods: A retrospective analysis of electronic medical records to 2011– 2021 was performed on symptoms, SPT-AA, AA-IgE, lung function, asthma therapy and bronchial provocation using Alternaria alternata extract (BP-AA). Results: 149 children and adolescents (5– 18 years) with Alternaria allergy were investigated. Between June and September, 86 Alternaria-sensitized patients had asthmatic symptoms and 113 had nasal symptoms (often outdoors or with mold exposure). SPT-AA and AA-IgE levels did not differ between the symptomatic and asymptomatic patients (SPT-AA, p= 0.23). A weak correlation was observed between the diagnostic tests in 49 patients with bronchial and/or nasal symptoms (r= 0.36, p= 0.01). Nineteen patients received provocation, 16 showed an early asthmatic response and 14 a late asthmatic response. Patients with BP-AA had a medium SPT-AA ≥ 7 mm or AA-IgE ≥ 16.8 kU/L. Both tests significantly correlate with PD20-AA (r= − 0,49, p< 0.01 and r= 0.26, p< 0.01, respectively). Conclusion: The Diagnosis of Alternaria allergy is still a challenge. The weak to moderate correlation between SPT-AA and AA-IgE seems to be allergen-specific. Typical medical history is a key diagnostic criterion. Allergy profiles and climate may play a role in the manifestation of symptoms. BP-AA help to establish threshold values for SPT-AA and AA-IgE. In unclear cases, nasal or bronchial provocation should be performed before immunotherapy. Keywords: allergic asthma, allergic rhinitis, skin prick test, serum-specific IgE, bronchial allergen provocation

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.