In children, allergic rhinitis is often part of the so-called allergic march. Allergic (Atopic) March, refers to the natural history or typical progression of allergic diseases that often begin early in life. These include atopic dermatitis (eczema), food allergy, allergic rhinitis (hay fever) and asthma.
Allergic (atopic) march (click here to enlarge the image).
Sensitization to outdoor aeroallergens (tree, grass, or weed pollens) was present in 9.5% of children aged 0 to 2 years and 18.2% of children aged 2 to 4 years being sensitized to pollens.
In particular, tree pollen was the primary sensitizer in these younger children, with prevalence rates approaching that of dust mite sensitization.
Tree sensitization is the most prevalent pediatric outdoor allergy.
The authors recommend a consideration of performing SPTs to trees in children, including those younger than 4 years. Particular consideration for tree SPTs should be given to those children younger than 4 years who have a diagnosis of asthma, recurrent wheezing, or suspicious symptoms outdoors during tree pollen season.
Allergic sensitization can help predict future risk of asthma:
Modified Asthma Predictive Index (API) (click to enlarge the image).
Ahmad R. Sedaghat et al. Characterization of tree allergy prevalence in children younger than 4 years. Annals of Allergy, Asthma & Immunology, 02/2014.