Common Diseases Clearly Related to Allergy and IgE Antibody

Three common diseases are clearly related to exposure to indoor allergens: asthma, rhinitis (hay fever), and allergic skin conditions (i.e., eczema and urticaria). Although specific causal genes have not been identified, the genetic predisposition for these diseases is well established. If neither parent has a history of allergy or atopy, a child has only a 0–19 percent chance of having a childhood allergic disease. If one parent has atopy, the risk rises to 31–58 percent; if both parents have atopy, the risk rises still further to 60–100 percent (Zeiger, 1988; Table 2-5). In addition, an earlier age of onset of allergic disease is related to a family history of atopy (Figure 2-5; Smith, 1988). Examples of the effects of these diseases on quality of life are provided in Box 2-1. The economic impact of these conditions was discussed briefly in Chapter 1.

TABLE 2-5 Prediction of Development of Sensitization or Allergic Disease in Childhood Based on Parameters Present During Infancy

Factor

Likelihood of Allergic Disease (%)

Parental atopy history

Both parents

60–100

One parent

31–58

Neither parent

0–19

Aeroallergen exposure assessed at age 1*

<10 µg Der p I/g of dust

6

>10 µg Der p I/g of dust

28

Serum IgE during infancy

Increased >1 standard deviation above geometric mean

75

Normal

5

Illness during infancy

Recurrent croup

58

Recurrent wheezing

36

Wheezing and blood eosinophilia

75

Wheezing and positive radioallergosorbent test

44

None of these illnesses

13

SOURCE: Zeiger (1988) and Sporik et al. (1990).

* The data on aeroallergen exposure, which were derived from Sporik and colleagues, were obtained from a cohort of newborns, each of whom had one parent with allergic disease. Asthma was defined as active wheezing and bronchial hyperreactivity. The numbers in parentheses show the percentage of all subjects who reported a history of wheezing. The relative risk of active asthma was 4.8 times greater if the child had been exposed to more than 10 µg of Der p I/g of dust in infancy. The percentage of sensitization for children exposed to less than 10 µg Der p I/g of dust was 31 percent; the percentage for children exposed to more than 10 µg was 56 percent.



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement