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Childhood Allergies: Why Different Symptoms May Share A Common Cause

<span>Childhood <a href="https://www.healthandme.com/health/allergies">allergies</a></span> rarely present as isolated issues. While one child may experience itchy skin and rashes, another may complain of a perennial runny nose and some wheeze a lot with infections, and yet others present with food-related symptoms. Although these are distinctly different manifestations, they could have a single root cause.

<h2>What Causes <span rel="noindex">Allergies</span> In Children?</h2>

<span>Childhood</span> <a href="https://www.healthandme.com/health-wellness/air-pollution-in-delhi-experts-warn-of-red-eyes-itching-watering-in-children-article-156456518" data-type="tilCustomLink">allergies</a> are basically an inappropriate immune response towards a substance that usually presents no harm, be it a food item or an allergen in the environment. However, it is not always easy to pick out what is causing the allergic response. The child's medical history as well as the nature and accompanying circumstances of the reaction, play a pertinent role in picking out what is precipitating the problem.

Two children may present with similar complaints but have different underlying allergic conditions. Understanding the pattern of the disease helps decide what investigations are needed and how best the condition can be managed.

Also read: <a href="https://www.healthandme.com/parenting/in-toeing-in-children-when-it-needs-assessment-article-156481076" data-type="tilCustomLink">In-Toeing In Children: When It Needs Assessment</a>

<h2>How Allergies Can Affect Multiple Body Systems</h2>

Allergic diseases can affect multiple body systems. The most common are the skin, upper respiratory tract and the lower respiratory tract. Skin allergy manifests as atopic dermatitis or urticaria, upper respiratory tract can cause allergic rhinitis and conjunctivitis and lower respiratory tract can manifest as asthma. 

There are also food allergies which could present with <a href="https://www.healthandme.com/health-wellness/ibs-is-not-just-a-gut-problem-lancet-review-explains-the-gut-brain-connection-article-156449476" data-type="tilCustomLink">gastrointestinal symptoms</a> or even more serious reactions. A child may also face multisystem involvement and this can sometimes be life-threatening like in a case of anaphylaxis.

<h2>Understanding The Role Of Type 2 Inflammation</h2>

Allergic disorders may present with multisystem involvement due to the fact that type 2 inflammation is a key driver in the pathology. Cytokines such as IL-31, IL-13 and IL-5 are integral to the formation of IgE antibodies and the activation of eosinophils. Genetic predisposition, skin barrier dysfunction, environmental exposure and the gut microbiota also contribute towards the development of allergies.

There is usually an evolution of allergic diseases as a child grows older. This is commonly referred to as the atopic march. It is common for a child to present with atopic dermatitis and then develop food allergies, allergic rhinitis or <a href="https://www.healthandme.com/health-wellness/with-delhi-aqi-nearing-400-pollution-flu-loom-ahead-of-diwali-what-happens-when-both-hit-your-lungs-article-156471011" data-type="tilCustomLink">asthma</a> later on in life. However, this is not always the case, and an allergic disorder cannot be extrapolated to the presence of any other based on this association alone.

Awareness to these associations can help parents and doctors to watch out for developing conditions and ensure early and appropriate intervention. For example, in a child presenting with persistent eczema, investigation for associated allergic disorders is vital if the history supports it. Early diagnosis and management can also help the parents identify red flags and seek help sooner.

Also read: <a href="https://www.healthandme.com/parenting/toddlers-swollen-knee-turned-out-to-be-juvenile-arthritis-diagnosis-signs-parents-should-not-ignore-article-156410683" data-type="tilCustomLink">Toddler’s Swollen Knee Turned Out To Be Juvenile Arthritis Diagnosis: Signs Parents Should Not Ignore</a>

<h2>How Are Childhood Allergies Diagnosed?</h2>

A thorough clinical history is an extremely valuable tool when it comes to diagnosing allergies. It is important for the doctor to know what the likely allergen was, how soon after exposure the symptoms cropped up, whether similar symptoms have occurred before, and what body systems are involved.

The timing of the reaction and whether it is a one-off or recurrent episode is important. A reaction occurring minutes after ingesting a certain food is very different from a food that causes symptoms after days of consumption.

<h2>Treatment And Management Of Allergies In Children</h2>

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Skin prick tests and specific IgE blood tests are commonly used to screen for sensitisation to common allergens, but these are just pointers. A positive test does not necessarily signify a clinically relevant allergy. The symptoms and exposure history must always be taken into consideration.

Testing for specific IgE to a panel of foods without a clear indication is not only misleading but can also be harmful. Parents may unnecessarily eliminate food groups from the child's diet based on a positive test, thereby affecting nutrition. Similarly, total IgE levels are not helpful in diagnosing a specific allergy.

The treatment varies from managing acute symptoms (with antihistamines or steroids) to controlling chronic conditions (with regular inhaled steroids for asthma). Avoiding the allergen where possible, and treating flare-ups appropriately are the cornerstones of management. Immunotherapy with allergen extracts may be indicated in selected patients with respiratory allergies. Biologics may be considered in certain conditions under specialist supervision.

<h2>Why Childhood Allergies Need A Holistic Approach</h2>

Children at risk of anaphylaxis should have a personalised action plan and an epinephrine auto-injector available at all times.

Childhood allergies should not be managed in isolation. The focus should be on the child as a whole rather than a single presenting complaint. Awareness and management of any associated conditions can help prevent potentially serious complications.

<strong><em>By Dr Gargi Mathur, Senior Paediatrician, <span rel="noindex">Shalby International Hospitals</span>, Gurugram</em></strong>

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Childhood allergies rarely present as isolated issues. While one child may experience itchy skin and rashes, another may complain of a perennial runny nose and some wheeze a lot with infections, and yet others present with food-related symptoms. Although these are distinctly different manifestations, they could have a single root cause.What Causes Allergies In Children?Childhood allergies are basically an inappropriate immune response towards a substance that usually presents no harm, be it a food item or an allergen in the environment. However, it is not always easy to pick out what is causing the allergic response. The child's medical history as well as the nature and accompanying circumstances of the reaction, play a pertinent role in picking out what is precipitating the problem.Two children may present with similar complaints but have different underlying allergic conditions. Understanding the pattern of the disease helps decide what investigations are needed and how best the condition can be managed.Also read: In-Toeing In Children: When It Needs AssessmentHow Allergies Can Affect Multiple Body SystemsAllergic diseases can affect multiple body systems. The most common are the skin, upper respiratory tract and the lower respiratory tract. Skin allergy manifests as atopic dermatitis or urticaria, upper respiratory tract can cause allergic rhinitis and conjunctivitis and lower respiratory tract can manifest as asthma. There are also food allergies which could present with gastrointestinal symptoms or even more serious reactions. A child may also face multisystem involvement and this can sometimes be life-threatening like in a case of anaphylaxis.Understanding The Role Of Type 2 InflammationAllergic disorders may present with multisystem involvement due to the fact that type 2 inflammation is a key driver in the pathology. Cytokines such as IL-31, IL-13 and IL-5 are integral to the formation of IgE antibodies and the activation of eosinophils. Genetic predisposition, skin barrier dysfunction, environmental exposure and the gut microbiota also contribute towards the development of allergies.There is usually an evolution of allergic diseases as a child grows older. This is commonly referred to as the atopic march. It is common for a child to present with atopic dermatitis and then develop food allergies, allergic rhinitis or asthma later on in life. However, this is not always the case, and an allergic disorder cannot be extrapolated to the presence of any other based on this association alone.Awareness to these associations can help parents and doctors to watch out for developing conditions and ensure early and appropriate intervention. For example, in a child presenting with persistent eczema, investigation for associated allergic disorders is vital if the history supports it. Early diagnosis and management can also help the parents identify red flags and seek help sooner.Also read: Toddler’s Swollen Knee Turned Out To Be Juvenile Arthritis Diagnosis: Signs Parents Should Not IgnoreHow Are Childhood Allergies Diagnosed?A thorough clinical history is an extremely valuable tool when it comes to diagnosing allergies. It is important for the doctor to know what the likely allergen was, how soon after exposure the symptoms cropped up, whether similar symptoms have occurred before, and what body systems are involved.The timing of the reaction and whether it is a one-off or recurrent episode is important. A reaction occurring minutes after ingesting a certain food is very different from a food that causes symptoms after days of consumption.Treatment And Management Of Allergies In Children   Skin prick tests and specific IgE blood tests are commonly used to screen for sensitisation to common allergens, but these are just pointers. A positive test does not necessarily signify a clinically relevant allergy. The symptoms and exposure history must always be taken into consideration.Testing for specific IgE to a panel of foods without a clear indication is not only misleading but can also be harmful. Parents may unnecessarily eliminate food groups from the child's diet based on a positive test, thereby affecting nutrition. Similarly, total IgE levels are not helpful in diagnosing a specific allergy.The treatment varies from managing acute symptoms (with antihistamines or steroids) to controlling chronic conditions (with regular inhaled steroids for asthma). Avoiding the allergen where possible, and treating flare-ups appropriately are the cornerstones of management. Immunotherapy with allergen extracts may be indicated in selected patients with respiratory allergies. Biologics may be considered in certain conditions under specialist supervision.Why Childhood Allergies Need A Holistic ApproachChildren at risk of anaphylaxis should have a personalised action plan and an epinephrine auto-injector available at all times.Childhood allergies should not be managed in isolation. The focus should be on the child as a whole rather than a single presenting complaint. Awareness and management of any associated conditions can help prevent potentially serious complications.By Dr Gargi Mathur, Senior Paediatrician, Shalby International Hospitals, Gurugram

childhood allergies: why different symptoms may share a common cause

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