ACAAI scientific meeting to discuss pediatric allergies

Nov 12 2010

Your child may be allergic to your holiday pumpkin pie, according to allergists at the annual scientific meeting of the American College of Allergy, Asthma and Immunology (ACAAI) in Phoenix, Nov. 11-16, 2010. Hot topics discussed in pediatric allergies include pumpkin and caterpillar allergies, and outgrowing childhood allergies.

Although pumpkin is not a food usually associated with allergic reactions, the Annals of Allergy, Asthma and Immunology, the scientific journal of the ACAAI, reported a case study of an 8-year-old boy with known asthma and food allergies who became sick after carving a pumpkin. His symptoms included itchy eyes, sneezing, eyelid swelling and chest tightness. Allergists say these symptoms can occur after carving or eating pumpkin.

"An allergic reaction to pumpkin can occur even if your child has had no prior reactions," said pediatric allergist John Kelso, MD, of the ACAAI Pediatrics and Literature Review Committees.

And although your little one may want to catch a caterpillar and see it become a butterfly, case studies show caterpillars can also cause allergic reactions in some children. Direct contact with caterpillars or breathing airborne caterpillar hairs can cause hives or respiratory symptoms. Extensive or prolonged exposure can cause life-threatening anaphylaxis.

"These may be rare allergies, but it may also be that we are just becoming more aware of them," said Dr. Kelso.

Pediatric allergists also presented new ideas on childhood allergies and asthma topics including:
•Outgrowing childhood allergies
•Asthma management update
•Paths of the "allergic march"

Outgrowing Childhood Allergies
The life cycle of childhood allergies was examined to determine how children's responses to airborne allergens - dust mite, cat, dog, grass and birch - changed over time. While it was known children can outgrow certain food allergies, airborne allergies were thought to only get worse with age. Researchers found that reactions to airborne allergies undergo tremendous changes throughout childhood; and mild allergies early in life frequently disappear as children grow.

"Not surprisingly, the stronger the existing allergic response, the less likely the allergy is to be outgrown," said Dr. Kelso. "What we learned was that low level allergic sensitization to airborne allergens in early childhood tends to be lost with the passage of time."

Asthma Management Update
Because asthma is a serious and sometimes life-threatening disease, allergists continue to focus on finding the right balance of therapies to keep asthma under control. Asthma sufferers should be able to feel good, be active all day and sleep well at night.

"Recent FDA label changes for Long-Acting Beta-Agonists (LABAs) mean possible changes for pediatric asthma management," said allergist Bobby Lanier, MD, ACAAI executive medical director. The label changes specify that LABAs should only be used with a controller medication, and discontinued once control is achieved.

"In fact LABA use can decrease the total dose of inhaled steroids needed, which in childhood asthma is important." said Dr. Lanier. "Allergists must weigh the risks and benefits for each patient."

Path of the Allergic March
It had been previously thought that allergic children "marched" predictably from eczema to asthma to allergic rhinitis. But recent research, which analyzed a database of more than 24,000 children, found while this is the most common path, it is not as predictable as once thought. Most children who develop one of these conditions will not develop the others. Those who do can start with any one of them and may develop the others in any order. Having eczema, asthma or allergic rhinitis makes children more likely to have one or more of the others, but there is not a conventional march from one to the next.