아토피피부염이 영유아의 식품알레르기 자연경과에 미치는 영향

박지선 ( Ji Sun Park ),문순정 ( Soon Jeong Moon ),임대현 ( Dae Hyun Lim ),장해지 ( Hae Ji Jang ),황선영 ( Sun Young Hwang ),박윤성 ( Yoon Sung Park ),김정희 ( Jeong Hee Kim ) 대한천식알레르기학회(구 대한알레르기학회) 2017 Allergy Asthma & Respiratory Disease Vol.5 No.5

Purpose: There have been studies showing that food allergy plays a role in the pathogenesis of atopic dermatitis. However, there have been few studies about the effect of atopic dermatitis on remission of food allergy. Thus, this study aimed to evaluate the dif-ference in remission according to the presence of atopic dermatitis in infants and young children with milk or egg allergy. Methods: A retrospective study was performed on 109 infants and young children with IgE-mediated food allergy in a tertiary hos-pital. They divided into food allergy with atopic dermatitis (FA with AD) and without atopic dermatitis (FA without AD). Results: In the milk allergy group, initial milk-specific IgE levels were 21.16±27.98 kU_A/L and 11.36±22.88 kU_A/L, respectively, in FA with AD and FA without AD under 12 months of age. The remission rates of milk allergy at 36 months of age were 64.9% and 90.0%, respectively, in FA with AD and FA without AD. In the egg allergy groups, initial egg-specific IgE levels were 34.48±36.72 kU_A/L and 15.66±28.60 kU_A/L, respectively, in FA with AD and FA without AD under 12 months of age. The remission rates of egg allergy at 36 months of age were 61.2% and 90.0% in children with FA with AD and FA without AD. Conclusion: Atopic dermatitis may play an important role in the natural history of food allergy in infants. Different strategies are needed for the management of food allergy in young children with atopic dermatitis. (Allergy Asthma Respir Dis 2017;5:256-261)

우리나라 소아 알레르기비염 환자에서 호기산화질소의 측정

문승현 ( Seung Hyun Moon ),장해지 ( Hae Ji Jang ),박윤성 ( Yoon Sung Park ),이우연 ( Woo Yeon Lee ),임대현 ( Dae Hyun Lim ),김정희 ( Jeong Hee Kim ) 대한천식알레르기학회 2015 Allergy Asthma & Respiratory Disease Vol.3 No.6

Purpose: Fractional exhaled nitric oxide (FeNO) is useful for the diagnosis of allergic rhinitis (AR) as well as bronchial asthma (BA). However, FeNO may differ according to race, age, and other determinants. There have been few studies about FeNO in Korean children with AR. The aims of this study were to evaluate the value of FeNO in AR and to compare FeNO, and determinants of FeNO levels between AR, BA, and combined AR and BA. Methods: This study included 647 children aged 5 to 17. The children were classified into 5 groups after performing the skin test, FeNO measurement, the pulmonary function test, and the methacholine challenge test: those with nonallergic rhinitis (NAR), those with AR, those with BA, and those with combined AR and BA, and healthy controls,. Results: The values of FEV1 (forced expiratory volume in one second) %predicted were 94.4%±12.6%, 93.8%±20.7%, 90.0%±17.4% in AR, BA, and combined AR and BA, respectively. The values of FeNO in AR (32.3±25.0 ppb), BA (31.1±20.5 ppb), and combined AR and BA (34.5±30.4 ppb) were significantly higher compared to those of NAR (16.8±13.5 ppb) and controls (15.9±12.5 ppb). There was no significant difference in FeNO among AR, BA, and combined AR and BA. FeNO was significantly higher in patients with ≥4 positive results (36.6±29.2 ppb) than in those with <4 positive skin test results (27.6±20.7 ppb). When the receiver operating characteristic curve analysis for prediction of AR showed 0.756 of area under the curve, the cutoff level of FeNO was 16 ppb. Conclusion: In this study, children with AR had increased levels of FeNO. It is suggested that AR may have eosinophilic bronchial inflammation without BHR or clinical asthma. (Allergy Asthma Respir Dis 2015;3:439-445)

소아 알레르기비염의 임상 특징

김재숙 ( Jae Sook Kim ),강희숙 ( Hee Suk Kang ),장해지 ( Hae Ji Jang ),김정희 ( Jeong Hee Kim ),임대현 ( Dae Hyun Lim ),손병관 ( Byong Kwan Son ) 대한천식알레르기학회 2015 Allergy Asthma & Respiratory Disease Vol.3 No.2

Purpose: The characteristics of allergic rhinitis can be different among countries and areas because causative allergens and aggra￢vating factors depend on the living environment. However, there have been few studies on the clinical feature of Korean children with allergic rhinitis, as well as on clinical characteristics in different age groups. The aim of this study was to investigate the clinical characteristics of Korean children with allergic rhinitis. Methods: The medical records of children under 12 years of age who had rhinitis symptoms were analyzed in terms of clinical symp￢toms and positive allergens. Subjects were classified into 2 groups: those with allergic rhinitis (AR group) and nonallergic rhinitis (NAR group). Both groups were subdivided into 3 categories: the 1-4 years, 5-8 years, and 9-12 age groups. Results: Among 516 children, 397 (76.94%) belonged to the AR group and 119 (23.06%) belonged to the NAR group. The male to female ratios were 2:1 in both groups. There were significant differences in sneezing and itching between the AR and NAR groups across different age subgroups. There were significant differences in nasal obstruction between the AR and NAR groups in the 9-12 age group. The incidence of AR was 77.8 % in chronic sinusitis patients. Sensitized allergens were house dust mites, animal hair, pol￢len, and mold in decreasing order in the AR group. Children who were sensitized to animal hair more frequently had sneezing than those who were not. Conclusion: Sneezing and itching strongly suggest allergic rhinitis in Korean children. Clinical characteristics of allergic rhinitis in Ko￢rean children would helpful in early diagnosis and adequate treatment of disease.(Allergy Asthma Respir Dis 2015;3:116-123)

중학생에서 “한국 알레르기비염 소아 삶의 질 설문”의 유용성평가

강하영 ( Ha Young Kang ),문승현 ( Seung Hyun Moon ),장해지 ( Hae Ji Jang ),임대현 ( Dae Hyun Lim ),김정희 ( Jeong Hee Kim ) 대한천식알레르기학회(구 대한알레르기학회) 2016 Allergy Asthma & Respiratory Disease Vol.4 No.5

Purpose: The quality of life questionnaire in Korean children with allergic rhinitis (QoL-KCAR) was developed to assess the quality of life in Korean children aged 6.12 years old with allergic rhinitis. The aim of this study was to validate the QoL-KCAR in Korean middle school students with allergic rhinitis. Methods: A survey with questionnaire and skin prick test was performed on 277 middle school students. The students were classi- fied into 3 groups: allergic-rhinitis (AR), non-allergic rhinitis (non-AR), and controls. AR was defined who had nasal symptoms within 12 months and positive response to skin test. Non-AR group was composed of students with nasal symptoms but had negative response to skin test. The rest who had no symptoms of rhinitis and negative response to skin test were classed as control group. QoLKCAR has 10 questions with 5-point scales for response options. Results: There were significant differences in the answer scores among the 3 groups (P<0.05). Total answer score is 20.9±10.2, 17.3±8.8, 4.4±5.6 in the AR, non-AR group, and control groups, respectively. It showed significant differences in all items between the AR and control groups, and 4 questions between the AR and non-AR groups. There were significant differences in total score and each score of 8 questions between before and after education in AR group. Conclusion: QoL-KCAR questionnaire can be useful for assessing quality-of-life in the Korean students aged 12 to 15 years old with allergic rhinitis as well as children aged 6 to 12 years old. (Allergy Asthma Respir Dis 2016:4:369-373)

광주 지역 소아청소년에서 알레르기비염 유병률과 주요 알레르겐 조사

권성은 ( Sung Eun Kwon ),임대현 ( Dae Hyun Lim ),김정희 ( Jeong Hee Kim ),손병관 ( Byong Kwan Son ),박윤성 ( Yoon Sung Park ),장해지 ( Hae Ji Jang ),김병희 ( Byung Hee Kim ),김근모 ( Geun Mo Kim ),유용상 ( Yong Sang Yoo ),박기원 ( 대한천식알레르기학회 2015 Allergy Asthma & Respiratory Disease Vol.3 No.1

Purpose: Allergic rhinitis (AR) is one of the most common childhood diseases in Korea. In this study, we aimed to investigate the prevalence and allergens of childhood AR in Gwangju. Methods: From April 2013 to September 2013 in Gwangju, skin prick test and questionnaire survey were performed targeting 2,330 children in total (350 kindergartners, 930 elementary school students, 589 middle school students, and 461 high school students). Results: The overall prevalence of AR was 23.5% (female 21.3%, male 26.1%). According to age groups, prevalence of AR was 14.9% (female 10.7%, male 19.8%) in kindergartners, 24.5% (female 18.8%, male 29.4%) in elementary school students, 23.3% (female 18.1%, male 27.6%) in middle school students, 26.2% (female 27.7%, male 23.2%) in high school students. The most common allergen was Dermatophagoides pteronyssinus (79.7%), followed by Dermatophagoides farina (72.2%), birch (14.0%), alder (12.0%), Japanese hop (9.2%), Alternaria (8.9%), cat fur (7.2%), Japanese cedar (6.9%), ryegrass (6.6%), willow (6.0%), pine (5.4%), oak (4.9%), mugwort (4.3%), orchard grass (4.0%), sheep fescue (3.7%), fat hen (3.4%), ragweed (3.4%), and maple (3.4%).Conclusion: This research figures out the prevalence and the detailed allergens of AR in Gwangju children. We suggest that more vegetation data of Japanese cedar should be surveyed in recent future.