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© Valérie Zeitoun
Stéthoscope. Centre Médical de l'Institut Pasteur (CMIP).
Publication : Archives de pediatrie : organe officiel de la Societe francaise de pediatrie

[Allergic march in children, from rhinitis to asthma: management, indication of immunotherapy]

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Archives de pediatrie : organe officiel de la Societe francaise de pediatrie - 04 Feb 2012

Scheinmann P, Pham Thi N, Karila C, de Blic J

Link to Pubmed [PMID] – 22306361

Arch Pediatr 2012 Mar;19(3):330-4

Allergic rhinitis (AR) is a common IgE dependent disorder. AR is maybe one of the steps of the allergic march, which starts with atopic dermatitis and food allergy and includes atopic asthma. AR and asthma are frequently associated. AR is frequently under-diagnosed and undertreated although it affects quality of life and school performance. Management of AR depends on its severity and will associate environmental control (best guided by environmental investigation and skin testing of specific IgE antibodies), pharmacotherapy (with antihistamines and intranasal corticosteroids as first line drugs). At present allergen immunotherapy is considered in patients with severe AR, insufficiently controlled by pharmacotherapy and who demonstrate specific IgE antibodies to relevant allergens. Sublingual immunotherapy is well tolerated. Only immunotherapy with the right allergens has the potential to alter the natural history of the allergic march, by preventing the development of new allergen sensitizations and reducing the risk for the subsequent development of asthma. This fact might extend the indications of specific allergen immunotherapy. Patients (and parents) education is of utmost importance in the management of allergic disorders.