Abstract
Recently, the atopic march (AM) is no longer considered a clear and sequential development of successive allergic diseases, such as atopic dermatitis (AD), asthma, and allergic rhinitis (AR). Recent studies have shown that associations between allergic disorders in children are much more complex, and there may be different variants of AM trajectories. Previously, eight classes of AM were described: (1) no allergic disorders, (2) AM, (3) AD and transient wheeze, (4) AD with later-onset rhinitis, (5) transient wheeze and later-onset rhinitis, (6) transient wheeze only, (7) eczema only, and (8) rhinitis only. 48.3% of children exhibit specific types of sequential development of allergic disorders, but only 7% exhibit profiles resembling ‘classic' AM. The aim of this article was to analyze AM trajectories in real clinical practice in children and to discuss the role of component resolved diagnosis (CRD) in the analysis of AM. The article presents anamnestic patient data and CRD results using a multiplex panel. The literature shows that AM classes do not always match the actual clinical presentation of a patient, indicating the presence of previously unreported AM trajectories. Molecular allergy diagnostics can identify true and cross-sensitization in complex clinical cases, allowing for consideration of the causes of established sensitization and conceptualization of clinical symptoms and individual AM trajectory. It is important to ensure that sensitization to true allergens is established and clinically verified. The analysis of anamnestic data can make it difficult to understand the sequence of allergic disease development. However, CRD significantly facilitates diagnostic search by allowing consideration of the order of sensitization and clinical manifestations. This can help predict the possible severity of allergic reactions to established allergens. KEYWORDS: atopic march, atopic dermatitis, allergic rhinitis, asthma, children, component resolved diagnosis, respiratory allergens. FOR CITATION: Lepeshkova T.S., Andronova E.V. Can component resolved diagnosis help establish "atopic march" trajectory? Russian Medical Inquiry. 2024;8(3):163–170 (in Russ.). DOI: 10.32364/2587-6821-2024-8-3-7.
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