Allergic manifestations in children

Within recent years numerous apparently diverse conditions such as asthma, hayfever, eczema, urticaria, migraine and other minor affections have been shown to have a similar etiologic basis, a hypersensitivity on the part of the sufferer to many usually harmless articles commonly encountered in his diet or environment. To this group of diseases the term ‘allergic’ has been applied; the individuals manifesting such an exaggerated susceptibility to substances innocuous to normal persons in the amounts commonly encountered are said to be ‘allergic’ to those articles; and the agents giving rise to those reactions in such apparently minute doses are termed ‘allergens’. When we analyse the origin of these allergic responses we find that they arise in one of two ways: either as a definite inheritance of a predisposition to manifest specific hypersensitiveness, or acquired as the result of tissue damage or excessive irritation.

Though the allergic tendency is prenatal in origin the actual manifestations and causative allergens generally depend upon postnatal factors. The site and type of reaction are frequently consequent upon some local strain or injury, and selectivity of the allergen generally follows repeated or continuous contact with some factor of diet or environment.

Allergic diseases have several characteristics in common the determination of which proves of the utmost importance in diagnosis. They are essentially periodic in nature with apparent intervals of freedom. The symptoms frequently have their onset at night or are most distressing during those hours.

With the exception of hayfever the different manifestations have their maximum onset during childhood or adolescence, and each manifestation appears to have definite sex and seasonal variations. In addition, allergic conditions are definitely affected by varied states of health of the sufferer, by intercurrent diseases, such as fever, exanthemata or climatological factors, locality, altitude or environment.

Varied manifestations of disease in childhood have been shown to fall into the allergic category. The commoner of these include such respiratory symptoms as recurrent bronchitis and asthma; such cutaneous eruption as eczema, flexural pruritis, urticaria including the popular and giant types, and purpura; such abdominal conditions as food-upsets, colic and recurrent vomiting, hayfever, migraine, enuresis and reactions to therapeutic serums and physical agents

Much can be done to prevent the development of allergic symptoms in children, especially children of allergic parents. The homes should be as free from dust and allergens as possible. New foods should be tried one at a time, at least a week apart, to see if symptoms occur. Asthmatic children should be guided away from dusty occupations. Exposure to colds should be minimized. Psychosomatic factors, if present, should be given proper attention.