Chapter 14 Managing the Allergic Child
Classification of the Problem
Children are usually classified by the allergic disorders from which they suffer. These are likely to include one or more of atopic dermatitis, atopic gastrointestinal disease (gastroesophageal reflux, food allergy, failure to thrive, eosinophilic esophagitis, etc.), atopic respiratory disease (asthma, rhinoconjunctivitis), anaphylaxis, urticaria (rarely allergic in childhood), and drug allergy. Children very rarely exhibit allergy to occupational allergens such as latex, nor to aspirin. An alternative classification is by allergen sensitivity – food allergy, inhalant allergy, or both.
Diagnosis
▪ History
A family history of atopic disease should be noted as well as a very detailed environmental history, feeding, pets, nursery placement, smoking in the home, etc. Many children lead complicated lives and live in a least two places – symptoms occurring at one only can give a clue to causation, for example the child who coughs when visiting his father who has a cat. Any treatments given, including alternative and complementary ones, need to be accurately recorded, plus the response to these.
Investigations
▪ Laboratory Tests
Other blood tests which may be useful are: