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Allergy & Asthma Advocate: Winter 2005
Parents of children under six years of age will often give the following health history regarding their children: “Madison has frequent colds that last for several weeks. Her friends have colds too, but they seem to recover quickly. Madison improves slowly, and she often develops an ear infection and cough with wheezing that lasts for several weeks after the cold. Her first symptoms of upper and lower respiratory symptoms have been present since she was approximately 12 months of age. Madison also had quite severe eczema until she turned three.” Children with this type of history are often frequent visitors to their healthcare provider for treatment of upper and lower respiratory infection, when the underlying disease cause could be allergies and asthma. There are guidelines that provide a predictive index for children under five years of age, relating to the possible development of asthma. This prediction is based on the following major and minor criteria:
In addition, at least one of the two major criteria or two of the three minor criteria:
After discussing the child’s medical history, the healthcare provider will do an examination to check for physical signs of allergies or asthma. They include:
Other signs and symptoms that signal allergies are also some of the underlying causes of ongoing illness, such as frequent sniffing, eye or nose rubbing, sneezing and dark circles under the eyes. After the child’s physical exam, if the healthcare provider suspects allergic disease, be prepared to provide the child’s environmental history:
Current research demonstrates that up to 85% of children who have been diagnosed with asthma are found to have positive skin tests to allergens that correlate with the patient’s symptoms and exacerbations. Allergy skin testing is considered the gold standard for identifying certain types of inhalant allergens. This testing is done in a physician’s office and involves placing a drop of a suspected allergen on your child’s skin followed by pricking the skin. If the patient is allergic to the antigen, a skin reaction will occur within 10-20 minutes. Most children tolerate this procedure well. In some instances, the physician may decide to order a blood test called RAST testing, instead of allergy skin testing for the child. Spirometry is a useful diagnostic lung function test that is ordered for patients who are over 6-8 years of age. Younger children cannot perform a reproducible test. Consequently, the diagnosis of allergy and asthma must be based on family and patient history, obvious signs and symptoms, as well as environmental exposure and allergy skin testing. Early diagnosis and treatment of allergies and asthma has proven that children may have a normal cold just like their friends. Research has repeatedly shown that early treatment does prevent further progression and control of allergies and asthma.
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© 1996-2008 · All Rights Reserved · American Academy of Allergy Asthma & Immunology |
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Detecting allergies and asthma at an early age
In addition to family history, be sure to provide the child’s health history since birth. Has he/she been treated for croup, recurrent bronchitis or pneumonia? As a parent, do you have any ideas regarding the triggering factors? It is important to include a list of past and present medications, including over-the-counter medications. Were the medications helpful? Did the child have reactions to any medications?