Association Between Migraine and Atopic Diseases in Childhood: A Potential Protective Role of Anti-Allergic Drugs.
BACKGROUND
Migraine is a common cause of headache in childhood. Several studies have investigated the association between migraine and atopic diseases, mostly in the adult population.


OBJECTIVE
This study aimed to investigate this association in children.


METHODS
A case-control study was conducted across 3 European tertiary care hospitals between June 2014 and August 2014. Cases (n = 229) were children aged 6-18 years consulting for a migraine episode. Controls in the same age range (n = 406) were consulting for a minor injury and did not have a history of recurrent headache. Logistic regression analyses tested the effect of atopic diseases and anti-allergic therapies on occurrence of migraine.


RESULTS
Children with migraine were more likely to have persistent asthma compared to absence of asthma (odds ratio [OR]: 4.57, 95% confidence interval [CI]: 2.04-10.24) and less likely to have been treated by inhaled or nasal corticosteroid (OR: 0.34, 95% CI: 0.15-0.76) or antihistamine therapy (OR: 0.33, 95% CI: 0.18-0.60). The median number of monthly migraine episodes was higher in children with persistent asthma (3; interquartile [IQR]: 1-4; range: 0.5-10) compared to children with intermittent asthma (2; IQR: 1-3; range: 0.1-4) or non-asthmatic children (2; IQR: 1-3; range: 0.1-12) (P < .01).


CONCLUSIONS
Persistent childhood asthma was associated with increased risk of migraine and higher frequency of migraine attacks. History of anti-asthmatic or anti-allergic therapies was associated with decreased risk of migraine in children and adolescents. The role of these therapies on the pathogenesis and occurrence of migraine needs to be further elucidated because of the huge potential impact in terms of public health.
Unit of Clinical Epidemiology, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, INSERM U1123 and CIC-EC 1426, Paris, France.
Camille
C
Aupiais
Pediatric Pneumology and Allergic Diseases Unit, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, Paris, France.
Stephanie
S
Wanin
Pediatric Migraine and Neurovascular Diseases Unit, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, INSERM U1141, Paris, France.
Silvia
S
Romanello
Department of Pediatrics, Luigi Sacco Hospital, Università degli Studi di Milano, Milan, Italy.
Daniele
D
Spiri
Department of Pediatrics, Azienda ospedaliero-universitaria Santa Maria della Misericordia di Udine, Italy.
Raffaella
R
Moretti
Unit of Clinical Epidemiology, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, INSERM U1123 and CIC-EC 1426, Paris, France.
Priscilla
P
Boizeau
Unit of Clinical Epidemiology, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, INSERM U1123 and CIC-EC 1426, Paris, France.
Davide
D
Massano
Department of Pediatrics, Luigi Sacco Hospital, Università degli Studi di Milano, Milan, Italy.
Gian Vincenzo
GV
Zuccotti
Department of Pediatrics, Azienda ospedaliero-universitaria Santa Maria della Misericordia di Udine, Italy.
Giovanni
G
Crichiutti
Basildon University Hospital, Essex, UK.
Lakshmi
L
Kanagarajah
Pediatric Pneumology and Allergic Diseases Unit, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, Paris, France.
Veronique
V
Houdouin
Unit of Clinical Epidemiology, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, INSERM U1123 and CIC-EC 1426, Paris, France.
Corinne
C
Alberti
Pediatric Migraine and Neurovascular Diseases Unit, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, INSERM U1141, Paris, France.|Department of Pediatric Emergency Care,Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, Paris, France.
Luigi
L
Titomanlio
D000293:Adolescent; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D002648:Child; D004342:Drug Hypersensitivity / Q000188:drug therapy* / Q000453:epidemiology*; D004636:Emergency Service, Hospital; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000188:drug therapy* / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008881:Migraine Disorders / Q000453:epidemiology*; D010290:Parents / Q000523:psychology; D012720:Severity of Illness Index
D018926:Anti-Allergic Agents
allergic rhinitis; asthma; children; epidemiology; migraine