Childhood allergies rarely present as isolated issues. another may complain of a perennial runny nose and some wheeze a lot with infections, and yet others present with food-related symptoms While one child may experience itchy skin and rashes. they could have a single root cause Although these are distinctly different manifestations.
Dr Gargi Mathur, Senior Paediatrician, Shalby International Hospitals, Gurugram, says that 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. Understanding the pattern of the disease helps decide what investigations are needed and how best the condition can be managed,” she says. A reaction occurring minutes after ingesting a certain food is very different from a food that causes symptoms after days of consumption,” Dr Mathur says.
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. 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. 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. “The timing of the reaction and whether it is a one-off or recurrent episode is important. Dr. Mathur warns, “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.”