Research In Practice Blog

Ped Allergies
Pediatric Allergies: Building the Evidence Base
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By Stanislaw J. Gabryszewski, MD, PhD

Intro
With the advent of collaborative electronic reporting consortiums and shared health data networks, the process of data translation has become more efficient. Now, researchers can conduct longitudinal, population-wide studies in a fraction of the time once required, so they can share valuable clinical and epidemiological findings that help improve child health and quality of life. For this research endeavor, our experts and their colleagues analyzed pediatric health data spanning more than two decades to further illuminate allergy development in children.

Study design & findings
The researchers conducted longitudinal analysis of nearly 220,000 children across varying demographics and various health systems who had documented atopic dermatitis (eczema), IgE-mediated (anaphylactic) food allergy), asthma, allergic rhinitis, or eosinophilic esophagitis (EoE - inflammation of the esophagus).

Their findings elaborated on current understandings of the “allergic march”—a population-level understanding of the progression of allergies from birth to adulthood. In the population studied, atopic dermatitis occurred earliest (peak age : 4 months) and was seen in about 10% of children. EoE occurred latest (peak age: 35 months) and was seen in <1% of children. Asthma was the most frequently documented allergy, seen in 20% of children. The study also showed that the most diagnosed anaphylactic food allergies were peanut, egg, and shellfish

Findings that differed from previous research included the higher percentage of non-white children affected by eosinophilic esophagitis and the lower prevalence of anaphylactic food allergy.

Implications
This was the first large-scale study of pediatric allergy patterns across distinct health systems in the United States, specifically using electronic health record information. Across the study population, the researchers found many instances of simultaneously occurring allergies, suggesting that food and respiratory allergies likely have overlapping genetic, environmental, and immunologic features—this warrants further study. The study provides important insights about patterns and prevalence of allergic conditions in children that are informative to both families and medical providers as they observe symptoms in children that could indicate the development of new allergies.

View this article’s video abstract here.

Check out these links for additional information & resources:

Clinical Futures authors: Robert W Grundmeier, MD; Alexander G Fiks, MD, MSCE

Additional authors from Children’s Hospital of Philadelphia: Stanislaw J Gabryszewski, MD, PhD; Jesse Dudley, MLIS; Jennifer A Faerber, PhD; David A Hill, MD, PhD

Gabryszewski SJ, Dudley J, Shu D, et al. Patterns in the Development of Pediatric Allergy. Pediatrics. 2023;152(2):e2022060531. doi:10.1542/peds.2022-060531