Is mold sensitization associated with severe asthma exacerbation in children?

Isree Leelayuwattanakul, Kittipos Visitsunthorn, Witchaya Srisuwatchari, Punchama Pacharn, Orathai Jirapongsananuruk, Nualanong Visitsunthorn

Affiliation:
Division of Allergy and Clinical Immunology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

Abstract

Background: Mold sensitization has been reported as a factor associated with severe asthma exacerbation (SAE).
Objective: To identify the factors associated with SAE in asthmatic children, particularly mold sensitization.
Methods: The asthmatic children recruited into this case-control study were classified into an SAE and an outpatient (OPD) group, based on their histories of asthma exacerbation with hospitalization in the preceding year. A skin prick test to common aeroallergens was performed. Possible SAE risk factors were analyzed.
Results: A total of 102 patients were enrolled. The 51 patients in the SAE group were significantly younger than the 51 in the OPD group (mean ages of 6.8 ± 3.3 vs 8.7 ± 3.2 years, p = 0.005). Higher proportions of patients with partly controlled or uncontrolled asthma were found in the SAE group (41.2% vs 17.6%, p = 0.009). The incidences of a paternal history of atopy, an emergency department visit, and a history of systemic corticosteroid administration in the preceding year were significantly higher for the SAE group (35.3% vs 15.7%, p = 0.023; 100% vs 43.5%, p < 0.001; and 100% vs 31.4%, p < 0.001; respectively). The multivariate logistic regression analysis showed that risk factors for SAE were Alternaria sensitization (adjusted odds ratio [AOR] 3.00; 95% CI 1.09–8.3; p = 0.033), patients who were younger than 6 years (AOR 3.28; 95% CI 1.17–9.18; p = 0.024), and a paternal history of atopy (AOR 2.94; 95% CI 1.05–8.25; p = 0.040).
Conclusions: Alternaria sensitization, an age younger than 6 years, and a paternal history of atopy were associated with SAE in asthmatic children.
Key words: Alternaria, asthma exacerbation, children, mold sensitization, severe asthma,