[Increase in orders for specific IgE tests and more positive results in children in 1985-2003]. / Meer aangevraagde tests op specifiek IgE bij kinderen in de loop van 1985-2003 en meer positieve uitslagen.

OBJECTIVE: To describe changes over time in the number of allergy tests for specific IgE ordered and outcomes in children, to help address the question whether the increase in allergies is due to an actual increase in sensitisation or an increase in diagnostic awareness of allergies among physicians. DESIGN: Retrospective and descriptive. METHOD: We reviewed the results of all specific IgE tests performed in our hospital's laboratory for children 0-18 years of age in the period 1985-2003. This included tests ordered by both general practitioners and hospital-based specialists. We analysed trends over time in the number of tests ordered (as an indicator ofdiagnostic awareness) and test results (as an indicator ofsensitisation). RESULTS: Between 1989 and 1995, the annual number of tests ordered increased from 1 per 10,000 children to 95 per 10,000 children and remained stable thereafter. Before 1990, more than 90% of tests were ordered by hospital-based specialists; after 1990, approximately 70% of the tests were ordered by general practitioners (p < 0.001). The proportion of positive tests remained stable at approximately 27% until 1991, after which it increased to more than 45% (p < 0.001). CONCLUSION: The increase in the proportion of positive tests suggests an increase in atopic sensitization between 1985 and 2000 which has stabilized since.

[Testing for specific immunoglobulins E (IgE) in case of suspected allergy in children: the results in a laboratory for general practitioners and medical specialists]. / Testen op specifieke immunoglobulinen E (IgE) bij vermoeden van allergie bij kinderen: resultaten in een laboratorium voor huisartsen en medisch specialisten.

OBJECTIVE: To describe the results of allergic sensitization tests to food and inhalant allergens in children younger than 4 years of age and in older children. DESIGN: Descriptive, retrospective. METHOD: The results of all specific IgE tests performed in children, 0-18 years ofage, in our hospital laboratory during the period 1985-2003 were reviewed. The hospital laboratory performed these tests for both general practitioners and specialists. RESULTS: During the study period, specific IgE tests were performed in 9131 children. Sensitization to inhalant allergens was found in 50% (3087/6185) of the children above 4 years of age and in 32% (9311/2946) of children 4 years of age or younger. Sensitization to house dust mite (12%), dog dander (9%), and cat dander (8%) was more common in young children than sensitization to pollen (7%) (p < 0.001). Sensitization to food allergens was found in 23% of schoolchildren and adolescents. Of these children, 48% were sensitized to 5 or more different inhalant or food allergens. In children 4 years of age or younger, paediatricians ordered most of the tests, while in the older children most tests were ordered by general practitioners. CONCLUSION: Sensitization to inhalant allergens is common in children 4 years of age or younger. Sensitization to food allergens is not confined to young children but is also frequently found in schoolchildren and adolescents. In such cases, there is often sensitization to several food and inhalant allergens, the clinical significance of which is usually unclear.

[Developmental delay in breastfed children due to inadequate diet of the mother]. / Ontwikkelingsachterstand bij borstgevoede kinderen door ontoereikend dieet van de moeder.

Two infant boys of 7 and 12 months respectively who presented with symptoms of failure to thrive and developmental delay were diagnosed with vitamin B12 deficiency. This deficiency is a rare condition in infants living in developed countries. It does occur, however, in infants who are breastfed by mothers with an inadequate diet. Both of the children studied were breastfed by vegetarian mothers. Following vitamin suppletion, both children showed signs of recovery. The importance of considering vitamin deficiencies in similar infants presenting with failure to thrive is emphasized. Moreover, maternal dietary habits in breastfed children should be checked. To prevent irreversible neurological damage, early recognition of any nutritional deficiencies is important.