BACKGROUND: For the diagnosis of asthma in young children, GPs have to rely on history taking and physical examination, as spirometry is not possible. The additional diagnostic value of specific immunoglobulin E (IgE) to inhalent allergens remains unclear. AIM: To assess the predictive accuracy of specific IgE to cat, dog, and/or house dust mites in young children for the subsequent development of asthma at the age of 6 years. DESIGN OF STUDY: Prospective follow-up study. SETTING: Seventy-two general practices. METHOD: A total of 654 children, aged 1-4 years, visiting their GPs for persistent coughing (>/= 5 days), were tested for IgE antibodies by radio allergosorbent testing (RAST). Parents completed a questionnaire on potential risk indicators. Those children who showed an IgE-positive status (12.7%) and a random sample of those with an IgE-negative status (<0.5 U/ml) were followed up to the age of 6 years when the asthma status was established. The main outcome measure was asthma at the age of 6 years (combination of both symptoms and/or use of asthma medication, and impaired lung function). RESULTS: Addition of RAST results to a prediction model based on age, wheeze, and family history of pollen allergy increased the area under the receiver operating characteristic (ROC) curve from 0.76 to 0.87. Furthermore, RAST improved patient differentiation as indicated by a change in the range of asthma probabilities from 6-75% before the IgE test, to 1-95% after the IgE-test. CONCLUSION: Sensitisation to inhalant allergens in 1-4-year-olds, as shown by RAST, is a useful diagnostic indicator for the presence of asthma at the age of 6 years, even after a clinical history has been obtained. This model should preferably be validated in a new population before it can be applied in practice.
BACKGROUND: For the diagnosis of asthma in young children, GPs have to rely on history taking and physical examination, as spirometry is not possible. The additional diagnostic value of specific immunoglobulin E (IgE) to inhalent allergens remains unclear. AIM: To assess the predictive accuracy of specific IgE to cat, dog, and/or house dust mites in young children for the subsequent development of asthma at the age of 6 years. DESIGN OF STUDY: Prospective follow-up study. SETTING: Seventy-two general practices. METHOD: A total of 654 children, aged 1-4 years, visiting their GPs for persistent coughing (>/= 5 days), were tested for IgE antibodies by radio allergosorbent testing (RAST). Parents completed a questionnaire on potential risk indicators. Those children who showed an IgE-positive status (12.7%) and a random sample of those with an IgE-negative status (<0.5 U/ml) were followed up to the age of 6 years when the asthma status was established. The main outcome measure was asthma at the age of 6 years (combination of both symptoms and/or use of asthma medication, and impaired lung function). RESULTS: Addition of RAST results to a prediction model based on age, wheeze, and family history of pollen allergy increased the area under the receiver operating characteristic (ROC) curve from 0.76 to 0.87. Furthermore, RAST improved patient differentiation as indicated by a change in the range of asthma probabilities from 6-75% before the IgE test, to 1-95% after the IgE-test. CONCLUSION: Sensitisation to inhalant allergens in 1-4-year-olds, as shown by RAST, is a useful diagnostic indicator for the presence of asthma at the age of 6 years, even after a clinical history has been obtained. This model should preferably be validated in a new population before it can be applied in practice.
Authors: Romain A Pauwels; Søren Pedersen; William W Busse; Wan C Tan; Yu-Zhi Chen; Stefan V Ohlsson; Anders Ullman; Carl Johan Lamm; Paul M O'Byrne Journal: Lancet Date: 2003-03-29 Impact factor: 79.321
Authors: M I Asher; U Keil; H R Anderson; R Beasley; J Crane; F Martinez; E A Mitchell; N Pearce; B Sibbald; A W Stewart Journal: Eur Respir J Date: 1995-03 Impact factor: 16.671
Authors: A L Wright; C J Holberg; W J Morgan; L M Taussig; M Halonen; F D Martinez Journal: Am J Respir Crit Care Med Date: 1996-04 Impact factor: 21.405
Authors: Demetra Z Rotsides; Inge F Goldstein; Stephen M Canfield; Matthew Perzanowski; Robert B Mellins; Lori Hoepner; Maxine Ashby-Thompson; Judith S Jacobson Journal: Respir Med Date: 2009-11-13 Impact factor: 3.415
Authors: Karina E van Wonderen; Lonneke B van der Mark; Jacob Mohrs; Ronald B Geskus; Willem M van der Wal; Wim M C van Aalderen; Patrick J E Bindels; Gerben ter Riet Journal: BMC Pulm Med Date: 2009-04-15 Impact factor: 3.317
Authors: Esther Hafkamp-de Groen; Hester F Lingsma; Daan Caudri; Alet Wijga; Vincent Wv Jaddoe; Ewout W Steyerberg; Johan C de Jongste; Hein Raat Journal: BMC Pulm Med Date: 2012-10-16 Impact factor: 3.317
Authors: L G D'Cruz; S A Husain; T Wells; C Morgan; P J Stanczyk; A Satgunarajah; J Kashir; B L Calver; L M Blayney; F A Lai Journal: J Aging Res Clin Pract Date: 2018-03-26