Quoi de neuf en allergologie pédiatrique en 2000 ?Revue de la littérature internationale dˈoctobre 1999 à octobre 2000

Abstract

The relation between maternal and childhood atopy may result from an increased intrauterine Th2 environment and high levels of Th2 cytokines in the milk of atopic mothers. The value of in vitro tests for early prediction of atopy is low, but high levels of eosinophil-derived proteins in nasal secretions of neonates may predict respiratory allergy. The prevalence of respiratory allergy has decreased in children living in rural areas, especially on farms. This may be related to exposure to mycobacterias, but the development of allergic conditions is independent of tuberculin reactivity and history of tuberculosis infection; however, the prevalence of asthma is decreased in young adults infected by Mycobacterium tuberculosis during childhood. High levels of eosinophils in the blood of children with bronchiolitis predict the development of persistent wheezing and asthma. Inhaled, oral and intravenous corticosteroids do not prevent relapses of bronchiolitis and persistent wheezing, but early hyposensitization has long-term beneficial effects on asthmatic symptoms. Results of prick-tests and specific IgE determinations are correlated with the severity of food allergy, and several studies confirm the diagnostic value of patch-tests with foods in children with atopic dermatitis associated with food allergy. Interesting cases of unexpected food allergies are reported (carob-induced anaphylaxis, and exercise-induced anaphylaxis to snails). Finally, children with spina bifida demonstrate a progressive sensitization to latex, in spite of a latex-free environment after the first surgical procedure(s), and the gelatin included in vaccines is highly immunogenic and allergenic.