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Improving the management of atopic disease
  1. S T Holgate1,
  2. G Lack2
  1. 1Division of Infection, Inflammation and Repair, School of Medicine, University of Southampton, Southampton, UK
  2. 2Paediatric Allergy abd Immunology, St Mary’s Hospital, London, UK
  1. Correspondence to:
    Dr S T Holgate
    Mailpoint 810, D, Centre Block, Southampton General Hospital, Southampton SO16 6YD, UK; s.holgatesoton.ac.uk

Abstract

Asthma, wheeze, eczema, and, to a certain extent, rhinitis are very common conditions among children. The prevalence of allergic disease in the general population has increased alarmingly over the past 25 years, particularly in Western industrialised countries. However, it is important to remember that the symptoms often associated with allergy can have other aetiologies. Evidence suggests that in most circumstances, only 30–40% of chronic allergic-type symptoms are due to allergy. Accurate diagnosis of the presence of allergy is therefore an important issue, particularly given the interventions that such a diagnosis may initiate. In this review, we examine management options for allergy, provide the evidence as to what proportions of patients with common allergic-type symptoms are actually allergic, and list other causes of such symptoms. The importance of allergy testing and the options available are described, particularly with reference to the role of the non-allergist.

  • DBPCFC, double blind, placebo controlled food challenge
  • IgE, immunoglobulin E
  • RCP, Royal College of Physicians
  • SIT, specific immunotherapies
  • allergy
  • asthma
  • eczema
  • diagnosis
  • rhinitis

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Footnotes

  • Competing interests: none