BOSTON — Although total immunoglobulin E levels were unrelated to severity of hospital stay, children experience increasingly intense hospital courses if they have a family history of asthma or prior pediatric eczema, according to a recent presentation at the American College of Allergy, Asthma and Immunology’s Annual Scientific Meeting.
“Previous studies have suggested that eczema contributes to atopic inflammation and is linked to higher levels of allergic sensitization and higher IgE levels,” Mona Liu, MD, from the Children’s Hospital of Los Angeles, told Infectious Diseases in Children. “We found that a history of eczema was significantly associated with longer length of stay and more use of continuous albuterol in children hospitalized for asthma.”
Pediatric eczema with accompanying family history was associated with a longer hospital stay among children hospitalized for asthma.
To examine the connection between allergic sensitization with total IgE and a higher intensity of hospital course observed in children admitted for asthma, the researchers conducted a study in which 39 patients with asthma-related hospitalizations were enrolled. Interviews were conducted to gather information on patient demographics, asthma history and use of controller medications, medical history, atopic history, family history and environmental history. This information was also obtained from medical records.
All participants were aged between 1 and 17 years, and all were tested for aeroallergen and total IgE testing using a blood draw. Liu and colleagues examined all information for analysis of outcomes concerning hospital course, including ICU admission, length of stay, oxygen requirement and hours of continuous albuterol.
Of the participants included, 56% were Hispanic and 21% were black. At least one allergen was confirmed in 95% of children, and a total serum IgE greater than 200 IU/mL was observed in 77% of participants; however, the total IgE count was not significantly related to the severity of hospital course.
Family history of asthma was a significant contributor to the need for pediatric ICU admission, with 62% of these children admitted compared with 14% without this connection. Longer lengths of stay (P = .05) and longer lengths of continuous albuterol administration (P = .017) were related to a history of pediatric eczema.
“We are currently working on a larger sample size to confirm our findings,” Liu said in an interview. “For children with asthma, identifying risk factors that suggest a more severe disease course could have implications on disease classification and personalizing treatment.” –by Katherine Bortz
Liu M, et al. OR046. History of eczema is associated with more severe hospital course in children hospitalized for asthma. Presented at: The ACAAI Annual Meeting; Oct. 26-30, 2017; Boston.
Disclosure: The authors report no relevant financial disclosures.