[The course of allergy: principles for early diagnosis, prevention and early therapy of allergic diseases].
Allergic diseases have a peculiar characteristic: at different ages of the child they present under different forms. The typical time course, where atopic children 'grow out' of one allergic disease (e.g. atopic dermatitis) but then suffer from the next form of allergic disease (e.g. allergic asthma) has been termed 'atopic march', or 'allergic march'. Various information can help to identify early in life those children at risk for engaging in this atopic march. Sensitization to hen's egg and mites during the first year of life, long-lasting sensitization to food allergens during the first two years of age and atopic dermatitis in early infancy have been found to be predictors of allergic sensitizations and/or allergic airway disease later on in childhood. Although today no measures are available to completely prevent any manifestation of atopy before disease onset, some measures can contribute to stop or at least slow down the progression of the allergic march. Breast feeding for a least 4 to 6 months, stepwise introduction of solid food after this age only and avoidance of highly allergenic food during the first year of life can help to achieve this goal, as do measures to reduce indoor allergen exposure (especially house dust mites). For selected patients suffering from atopic dermatitis who are sensitized to grass pollen and/or house dust mites and who have highly motivated parents an early treatment with an antihistamine (cetirizine) can be considered.
Lauener
R
R
Universitäts-Kinderklinik Zürich. Srlauener@kispi.unizh.ch
Eigenmann
P
P
D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D012307:Risk Factors