Exhaled nitric oxide, total serum IgE and allergic sensitization in childhood asthma and allergic rhinitis

Exhaled nitric oxide (eNO) levels are correlated with several markers of atopy and inflammatory activity in the airways, but the relationship between eNO and total serum IgE has not been fully elucidated in the context of allergic sensitization. The aim of this study was to investigate the relationship between eNO, total serum IgE and allergic sensitization in childhood asthma and allergic rhinitis. eNO levels, lung function, skin prick tests and total serum IgE were determined in 109 children (mean age, 10.4 yr) with mild intermittent asthma and in 41 children (mean age, 10.1 yr) with allergic rhinitis; 25 healthy non-atopic children were recruited as controls. eNO levels (median) were significantly higher in patients with asthma (22.7 p.p.b.) and in those with allergic rhinitis (15.3 p.p.b.) than in healthy controls (5.9 p.p.b.). Children with allergic asthma had higher eNO levels than children with allergic rhinitis. A significant positive correlation was found between eNO and total serum IgE (asthma, r = 0.42, p < 0.0001; allergic rhinitis, r = 0.31, p < 0.01), and between eNO and the number of positive skin prick tests (asthma, r = 0.31, p < 0.0001; allergic rhinitis, r = 0.39, p < 0.01). eNO levels were better correlated with total IgE than with the number of positive skin prick tests. This correlation was independent of allergic sensitization. High total serum IgE represents a specific and predictive marker of eNO increase in children with asthma or allergic rhinitis. This finding adds further support to the hypothesis that increased serum IgE could be a marker itself of airway inflammation in patients with allergic disease.     

Local allergic rhinitis: A critical reappraisal from a paediatric perspective

The so‐called local allergic rhinitis (LAR) has been proposed as a phenotype of rhinitis with Th2‐driven prominent local allergic inflammation, nasal synthesis of specific IgE and a positive response to a nasal allergen provocation test, in the absence of ‘systemic’ atopy (negative skin prick test and serum allergen‐specific IgE antibodies). To date, available data on LAR are mostly focused on adults. The purpose of this ‘Rostrum’ was to critically discuss data and implications of the ‘LAR concept’ in paediatrics. In the natural history of rhinitis due to IgE‐mediated reactions triggered by exposure to allergens, a ‘LAR’ can be either the initial, transient stage of classical allergic rhinitis or a stable phenotype never evolving to ‘systemic’ IgE sensitization. Given the present difficulties in performing routinely nasal allergen provocation test in children, the development of sensitive and specific tests to detect IgE in the child's nasal secretions is a research priority. We suggest also the hypothetical role of allergen immunoprophylaxis or immunotherapy in LAR. Last, the term ‘local allergic rhinitis’ may be inappropriate, as rhinitis is always ‘local’, while IgE sensitization can be either ‘local’ or ‘systemic’.     

Respiratory allergy to moth: the importance of sensitization to Bombyx mori in children with asthma and rhinitis

Objectivethis study aimed to prepare a silkworm moth (Bombyx mori) antigenic extract and to perform skin prick tests with this extract in patients with allergic respiratory diseases; to evaluate serum specific immunoglobulin E (IgE) to Bombyx mori using ImmunoCAP® system and to report the frequency of positivity between the two methods and with clinical data.Methodsthis was a cross‐sectional study with 99 children and adolescents diagnosed with asthma and/or allergic rhinitis, who had skin reactivity to at least one of the six aeroallergens tested. Clinical data were evaluated: skin prick tests with Bombyx mori in‐house extract, and total and specific IgE analysis using ImmunoCAP® were performed.Resultsthe frequency of Bombyx mori specific IgE was found to be 52.5% and 60% using the skin prick test and ImmunoCAP®, respectively. An association between a positive skin test for Bombyx mori and the presence of allergic rhinitis, atopic dermatitis, and urticaria was observed, but the same was not true for asthma or allergic conjunctivitis. There was no relation with the severity of asthma or rhinitis symptoms.Conclusionsa high frequency of sensitization to Bombyx mori was observed in a selected population of patients with respiratory allergic diseases in the city of Curitiba, state of Paraná, Brazil. The extract prepared from the wings of this moth species is effective in demonstrating this sensitivity.     

Atopy patch testing in children with asthma and rhinitis symptoms allergic to house dust mite

The atopy patch test (APT) is generally used to assess immunoglobulin E (IgE) mediated sensitization to allergens in patients with atopic dermatitis, but its diagnostic role in children with respiratory allergy is still controversial. The aim of the study was to evaluate APT with house dust mite (HDM) in children with asthma and rhinitis symptoms allergic to HDM and its relevance to skin prick test (SPT) diameters and specific IgE levels. The study population consisted of 33 children, aged 8-16 yr (median: 12 yr) with asthma and 30 children with allergic rhinitis in the same age range (median: 11 yr). All patients had positive SPT results and high serum specific IgE levels for Dermatophagoides pteronyssinus APT was performed on back skin of all patients with 200 index of reactivity (IR)/ml of D. pteronyssinus allergen extracts in petrolatum (Stallerpatch) and evaluated at 72 h. Of 63 patients, 16 (25%) showed a positive patch test result. APT with HDM showed 30% (10/33) positivity among the patients with asthma and 20% (6/30) positivity among the patients with allergic rhinitis. APT presented no significant correlation with age, SPT diameter, serum total and specific IgE levels for D. pteronyssinus, nasal provocation test or pulmonary function test results. Patch testing with HDM may partly identify mite sensitive children with respiratory allergy. Positive APT results may imply that delayed hypersensitivity reactions play a role in children with asthma and rhinitis allergic to HDM.     

The prevalence of atopic disorders in children with chronic otitis media with effusion

We studied 209 children, referred to a multi‐disciplinary ‘Glue ear/Allergy’ clinic at our hospital with a history of chronic or recurrent otitis media with effusion (OME), in order to determine the prevalence of atopic disease in this population. Referrals were made either from within the hospital by Ear, Nose and Throat (ENT) Surgeons and Audiological Physicians (internal), or by General Practitioners (external). Assessment of atopic status was based on medical history, physical examination, nasal smears and skin‐prick testing (SPT) in all children; and on blood eosinophil counts and total immunoglobulin E (IgE) levels in a randomly selected subset. The main outcome measures were number of children with rhinitis, asthma, eczema, positive SPT, raised IgE level (> 100 IU/l), and nasal and blood eosinophilia. We found allergic rhinitis in 89%, asthma in 36%, and eczema in 24%. SPTs were positive to one or more of eight common inhalant aeroallergens in 57% of children. Blood tests in the selected subset revealed eosinophilia in 40% and a raised serum IgE in 28%. The worldwide prevalence of allergic rhinitis in children has been estimated to be 20%. The 89% prevalence found in this study is very high and there are a number of reasons which suggest that there may be a causal relationship. Whole‐population studies will be required to confirm these findings, which could have important therapeutic implications for OME.     

苏州大学附属儿童医院支气管哮喘及过敏性鼻炎患儿皮肤点刺试验结果分析

目的　应用皮肤点刺试验了解支气管哮喘及过敏性鼻炎患儿的主要过敏原, 为其预防、 诊断、 治疗提供依据。方法　选取于2015年8月至2017年7月在苏州大学附属儿童医院门诊诊断为支气管哮喘及过敏性鼻炎的2252例患儿进行皮肤点刺试验检测过敏原,并对其性别、 疾病种类数据采用SPSS 21.0软件进行分析。结果　2252例患儿进行皮肤点刺试验, 1390例阳性, 阳性率61.7%。男女比例1.75∶1, 男性阳性率（925/1433, 64.5%）高于女性阳性率（465/819, 56.8%）, 差异有统计学意义（P＜0.05）。支气管哮喘患儿阳性率为65.3%（607/929）, 过敏性鼻炎患儿阳性率为58.8%（664/1129）, 支气管哮喘合并过敏性鼻炎患儿阳性率61.3%（119/194）。支气管哮喘阳性率高于过敏性鼻炎, 差异有统计学意义（P＜0.05）。过敏原以粉尘螨（60.3%）、 屋尘螨（43.4%）最常见, 其次是草花粉、 猫毛。结论　苏州大学附属儿童医院的支气管哮喘、 过敏性鼻炎患儿最常见过敏原为螨类; 皮肤点刺试验可为过敏性疾病的诊断提供依据。     

体内和体外变应原测定在过敏性哮喘诊断中的联合应用

目的分析变应原皮肤点刺试验(SPT)和血清吸入性变应原筛查(Phadiatop)及特异性IgE测定联合应用在过敏性哮喘变应原诊断中优势。方法对57例诊断哮喘患儿进行吸入性变应原SPT测定和Phadiatop测定。对其中33例进行血清户尘螨特异性IgE测定。分析本组哮喘患儿SPT结果分布,SPT与Phadiatop结果符合率,户尘螨SPT与其特异性IgE结果符合率。结果儿童哮喘吸入性致敏原分布最常见的为尘螨、真菌、宠物等室内变应原。本组SPT和Phadiatop阳性检出率分别为86%、79%,SPT与Phadiatop符合率86%。5例Phadiatop阴性患儿经SPT和真菌特异性IgE测定证实存在真菌过敏。户尘螨SPT和特异性IgE结果符合率为97%。结论在儿童哮喘相关吸入性变应原诊断中,联合应用体内和体外变应原测定方法可互为补充,有助于提高变应原诊断的敏感性和特异性。     

Total IgE in urban Black South African teenagers: The influence of atopy and helminth infection

Total IgE levels are usually elevated in allergic diseases, being highest in atopic eczema, followed by atopic asthma and allergic rhinitis. Genetic factors are believed to play a role in total IgE levels, with higher levels seen in Black African subjects. Total IgE is also raised in parasite infection. Thus, the higher total IgE levels in Black Africans could be because of environmental rather than genetic factors. Few studies have investigated the usefulness of total IgE levels in the evaluation of atopy in Black Africans. The objective of this study was to determine the total IgE levels in unselected urban Black African high school children and to correlate this with atopy and ascaris sensitization. Atopic status was assessed by means of specific allergen sensitization (skin prick tests to eight inhalant and four food allergens), self-reported asthma and bronchial hyper-responsiveness measured by methacholine challenge. Ascaris sensitization was assessed by means of ascaris IgE measured by CAP-RAST. Total IgE levels were markedly skewed toward the left and were not distributed in a Gaussian or a log-normal distribution. Skin prick tests were positive for aeroallergens in 32.3% of subjects. Thirty four percent had elevated ascaris IgE. Total IgE was higher in atopic vs. non-atopic subjects and correlated with the number of positive skin prick tests, self-reported asthma and bronchial hyper-responsiveness. Subjects without allergy (or) atopy had a median total IgE of 80–90 kU/I. In addition total IgE correlated with ascaris IgE. Subjects with no ascaris sensitization had median total IgE of 77.1 kU/l. Subjects with neither atopy/asthma nor ascaris sensitisation had a median total IgE of 69.9 kU/I, similar to the levels seen in people of other genetic origins. This study suggests that helminthic infection rather than genetic differences, may be the major determining factor of IgE levels in certain populations.     

SERUM IMMUNOGLOBULIN E IN ATOPIC AND NON-ATOPIC CHILDREN AGED 6 MONTHS TO 5 YEARS

ABSTRACT. In order to obtain serum IgE reference values for small children we measured the total serum IgE concentration at the ages of 6 months, 1, 3, and 5 years in 66 healthy, non-atopic children who were followed from birth to 5 years of age. From this reference group we had excluded children with symptoms or signs of atopy during the follow-up period, as well as children with blood or nasal smear eosinophilia or positive skin prick tests. We also studied serum IgE levels in groups of children having latent atopy, symptomatic atopy, or severe atopic disease. We suggest that in the definition of reference values the upper limit of normal should be replaced by a zone of uncertainty, lying between the 95th and 97.5th percentiles. Serum IgE is a useful test with high specificity but low sensitivity in the differentiation between atopy and non-atopy. Thus high levels suggest atopy, while normal or low values yield little information. A normal serum IgE level does not necessarily exclude atopic disease.     

Value of a multiantigen radioallergosorbent test in diagnosing atopic disease in young children

The purpose of this study was to investigate the value of a new multiantigen radioallergosorbent test, Phadiatop Paediatric, in the diagnosis of atopy in children less than 7 years of age. The diagnosis of atopic disease was established by history, physical examination, total serum IgE concentration, and the results of prick skin tests or radioallergosorbent tests or both, and then compared with the result of the Phadiatop Paediatric test for each patient. One hundred two patients (62 boys) between the ages of 4 months and 7.3 years were enrolled (median age 3.2 years). After the history and physical examination, 42% of the patients were believed to be atopic and 32% to be nonatopic; the diagnosis was uncertain in 26%. Skin prick test reactions to a variety of foods and inhalants were positive in 41 of 63 children tested; results of radioallergosorbent tests were positive in 35 of 61 children. Overall, atopy was diagnosed in 53 children and 49 were found to be nonatopic. When the clinical diagnosis was used as the gold standard, the Phadiatop test resulted in a correct diagnosis of atopy in 49 of 53 cases and of no atopy in 43 of 49 cases: sensitivity = 92%, specificity = 88%, and efficiency = 90%. Although the Phadiatop Paediatric test does not indicate specific sensitivities, it provides the clinician with a useful screening test for atopic disease in children 7 years of age or less, and the researcher with a means of validating atopic populations.     

The relationship among markers of allergy, asthma, allergic rhinitis, and eczemain Costa Rica

The association between allergy markers and asthma and allergic rhinitis is stronger in countries with a Western lifestyle than in rural areas of Africa and Asia. We examined the relationship among allergy markers, asthma, rhinitis, and eczema in a case-control study of 198 schoolchildren, 10–13 years of age, living in Costa Rica, a Latin American country. The geometric mean total serum immunoglobulin E (IgE) level in subjects with and without asthma was 465.0 and 143.0 IU/ml, respectively (difference = 322 IU/ml, 95% CI = 141.8–616.1 IU/ml, p < 0.001), and that in subjects with and without allergic rhinitis was 442.5 and 144.3 IU/ml, respectively (difference = 298.2 IU/ml, 95% CI = 125.7–581.0 IU/ml, p < 0.001). After adjusting for age, gender, and skin test reactivity to allergens, we found a linear relationship between serum total IgE level and the log odds ratio (OR) of having asthma. In a multivariate analysis, there was a linear relationship between skin test reactivity to allergens and the log OR of having allergic rhinitis. The OR of having allergic rhinitis was almost three times higher in children who had four positive skin tests than in non-reactors. Skin test reactivity to greater than five aeroallergens was an independent predictor of eczema in a multivariate analysis (OR = 3.1, 95% CI = 1.1–8.4). Although the geometric mean total serum IgE levels of Costa Rican children with either asthma or allergic rhinitis are higher than those of children with asthma or allergic rhinitis in most industrialized countries, the relationship among markers of allergy, asthma, rhinitis, and eczema in Costa Rica is similar to that found in countries with a Western lifestyle and different from that found in rural areas of Asia and Africa.     

具有喘息症状或过敏性疾病的年幼儿皮肤点刺试验结果分析

目的：通过分析0~5岁儿童变应原皮肤点刺试验结果,了解具有喘息症状的可疑哮喘及过敏性疾病症状的患儿对吸入变应原过敏反应的特点,为儿童哮喘及过敏性疾病的早期诊断提供依据。方法：选择2010年9月1日至12月31日长沙市某社区0~5岁具有喘息症状或过敏性疾病症状的患儿共102例为变应原筛查组;对照组选择同年龄组无喘息及过敏性疾病史的儿童94例。两组均进行变应原皮肤点刺试验。结果：变应原筛查组皮肤点刺试验阳性率61.8%（63/102）明显高于对照组的9.6%（9/94）,差异有统计学意义（P<0.05）;反复喘息合并过敏性鼻炎者的皮肤点刺试验阳性率明显高于单纯喘息组（P<0.05）;喘息次数与皮肤点刺试验阳性率呈正相关（r=0.91,P<0.05）;对螨虫的皮肤点刺试验阳性率（24.2%）明显高于其他过敏原（3.5%）,差异有统计学意义（P<0.05）;粉尘螨的皮肤点刺阳性率（50.0%）明显高于屋尘螨（14.7%）,差异有统计学意义（P<0.05）。结论：早期儿童喘息可能是发生过敏性哮喘的重要因素;变应原皮肤点刺试验是诊断过敏性疾病的重要依据,并有助于评估喘息患儿对吸入性变应原的过敏反应特点。     

Evaluation of the need for routine preoperative latex allergy tests in children

BACKGROUND: Recently, there was a great increase in allergic reactions to latex and this brought relatively more concern to the latex allergy. In this prospective study we aimed to identify the frequency of latex allergy in preoperative patients, and tried to clarify whether it is necessary to perform latex allergy tests routinely in the preoperative period or not. METHODS: A total of 188 children, aged 1-14, who were admitted for various operations, were randomly included in this study and of them, 181 completed the study. Latex specific history was taken from all patients. Latex skin prick tests, challenge tests with latex gloves, total IgE and latex specific IgE measurements were performed. RESULTS: Of 181 children, two (1.1%) had positive latex skin prick tests. Latex challenge tests were negative in all children. Latex specific IgE was positive in 12 children (6.6%) as class II or higher, but no patient had allergic reactions in operations. History of repeated operations was a risk factor for latex sensitization. The risk was higher in the presence of both history of repeated operations and history of allergic disease. However, the risk was not higher in patients with the history of only allergic disease, compared to ones who had a history of neither repeated operations nor allergic disease. CONCLUSION: We conclude that routine preoperative latex allergy tests seem to be not necessary because of no allergic reactions during operation in spite of the sensitization of 6.6% detected by latex specific IgE. However, this should be investigated in larger studies.     

Latex allergy and associated risk factors in a group of Turkish patients with spina bifida

Allergic reactions to latex are common in patients with spina bifida. Its incidence varies between 28% and 67%. The aim of this study was to investigate the incidence of latex allergy and its risk factors in patients with spina bifida in Izmir, Turkey. Forty-six patients (24 male, mean age 10 years) were included in the study. A questionnaire was completed and skin prick tests with latex solution and cross-reacting foods were performed. Total IgE levels, specific IgE to common aeroallergens (Phadiotop), and latex specific IgE levels were measured. Patients with positive skin test reaction and/or who had specific IgE to latex without clinical symptoms were considered as sensitive to latex. The patients who also had clinical symptoms with latex exposure were diagnosed as allergic to latex. Latex sensitivity was found in 5/46 patients (10.8%). Only two patients had latex allergy (4.3%). Total IgE levels were higher (median 157 vs. 40 kU/L, p=0.012) and the duration of clean intermittent catheterization was longer insensitized patients when compared to non-sensitized patients (median 8 vs. 3 years, p=0.015). Specific IgE to common aeroallergens and positive skin prick test to cross-reacting foods were more prevalent in sensitized than in non-sensitized patients (p=0.02 and 0.015, respectively). The incidence of latex allergy in our group was lower than reported in the literature. This result may be due to the low number of surgical interventions. High levels of total IgE, positive Phadiotop, positive skin prick test to cross-reacting foods and the duration of clean intermittent catheterization are the risk factors for latex sensitivity in patients with spina bifida.     

Practical aspects of allergy-testing

Allergy-testing is a prerequisite for specific allergy treatment, including specific allergen avoidance measures, relevant pharmacotherapy and specific allergy vaccination. All children with persisting, recurrent or severe possible "allergic symptoms" or those with a need for continuous treatment should be tested, irrespective of the child's age. Allergy-testing includes a careful case history and a determination of IgE sensitisation by skin prick test or the measurement of allergen-specific IgE in serum by standardised and validated methods. The diagnosis of food allergy cannot usually be based solely on the case history and IgE sensitisation; the diagnosis has to be confirmed by controlled food elimination and food challenge procedures. The diagnosis of inhalant allergic disease requires only confirmatory nasal, conjunctival or bronchial challenges in equivocal cases or before specific allergy treatment such as extensive allergen avoidance measures or allergy vaccination.     

Agreement of specific IgE and skin prick test in an unselected cohort of two-year-old children

The objective of this study was to evaluate the agreement between specific IgE (sIgE) and skin prick test (SPT), and the possible association between total IgE concentration and allergy-related disorders, when performed in an unselected cohort of 353 two-year olds. Median total IgE was within the reference value for two-year-old children regardless of the presence or absence of allergy-related disorders. 18.7% of the children had one or more positive reactions to SPT and/or sIgE in a panel of 12 allergens. Agreement between SPT and sIgE was variable, being best for peanut and poorest for milk. Conclusion: In young children total IgE is of limited value when evaluating allergy-related disorder. The lack of agreement among the positive tests of the sIgE and SPT for some allergens imply that these tests should not be used interchangeably, and both tests should probably be used complementarily when diagnosing atopic sensitization in small children.     

Which cereal is a suitable substitute for wheat in children with wheat allergy?

Wheat is one of the main food allergens. It is among widely used cereals and there is an extensive cross-reaction between cereals. The aim of this study is to evaluate the extent to which cereals cross-react and to find the best substitute for wheat. Eighteen patients with definite diagnosis of type I hypersensitivity reactions to wheat enrolled in this study. Measurement of serum-specific IgE and skin prick test (SPT) for cereals flour (wheat, barley, oat, rye, rice and corn) and wheat bran was carried out. Also, open food challenge tests with available and conventional cereals in Iranian food culture (wheat, corn, rice and barley) were carried out. The SPTs were positive in 44.4% of patients for barley, 94.5% for wheat and 44-77% for other cereals. Positive serum-specific IgE was remarkable for wheat and barley and there was correlation between wheat and barley-specific IgE concentrations (r = 0.773 and p < 0.01). Corn serum-specific IgE was measured in 10 patients, which were positive in six of them. Of the patients, 55.5% had positive barley challenge tests, but all corn and rice challenge tests were negative. The best substitutes for wheat in wheat allergic patients are rice and corn. Regarding the correlation of wheat and barley serum-specific IgEs, there might be a high antigenic cross-reaction, therefore barley is not a good substitute for wheat and consuming barley needs a careful challenge test. Considering concordance of positive SPT to wheat flour and wheat bran, avoiding both of them is necessary in patients with wheat allergy.     

Skin prick test predictive value on the outcome of a first known egg exposure in milk-allergic children

Children with milk allergy have higher incidence of other food allergies, especially egg allergy. The objective of this study was to ascertain the accuracy of the prick test in children with IgE-mediated milk allergy for diagnosing egg allergy. Children under the age of 1 yr who came consecutively to Allergy Department 2003–05, and were diagnosed with IgE-mediated milk allergy were selected for this study. Egg introduction was completely avoided until the age of 14 months when clinical history, skin prick tests (SPT), specific-IgE antibodies determination and egg challenge test were performed. One hundred and four milk-allergic children were included. At least one positive prick test to any egg allergen was found in 65 out of the 104 (62.5%). Thirty-eight (36.5%) were allergic to egg proteins as well. Prick tests with egg white and ovomucoid (OVM) had the best diagnostic performances showing the largest areas under the receiver operating characteristic curve. The optimal diagnosis cut-off point was 6 mm for egg white and 5 mm for OVM. The positive likelihood ratios for these cut-off points were: 2.95 (95% CI: 1.74–4.99) for egg white prick test, and 20 (95% CI: 2.9–143.7) for OVM prick test. Children with specific IgE-mediated cow's milk allergy must be closely followed as a risk group for egg allergy. Early diagnosis is necessary and the SPT has shown itself to be a very useful tool for diagnosing immediate IgE reactions to egg on first known exposure.     

Efficacy of specific immunotherapy in children with seasonal allergic rhinitis and conjunctivitis,sensitized to grass pollen

The aim of this study was the evaluation of efficacy of the specific immunotherapy using Pollinex for 3 years before the period of pollen dust in children with seasonal allergic rhinitis and conjunctivitis induced by grass pollen. The study was carried out in a group of 40 children aged 5-18 years, from the Outpatient Department of Immunology at the National Research Institute of Mother and Child. The children demonstrated clinical symptoms of seasonal allergic rhinitis with conjunctivitis and had a medical history typical for this disease. Diagnostic procedures including skin prick tests and estimation of specific IgE to grass pollen by Pharmacia - CAP system, gave positive results. The efficacy of therapy was monitored by a clinical score with 4-0 points, recording symptoms relating to intensity of rhinoedema, rhinorrhea, sneezing, itching, oedema, conjunctival congestion, pain and lacrimation. In the study group, 39 children (97%) with seasonal rhinitis and conjunctivitis treated by specific immunotherapy (Pollinex) improved. This was confirmed by a statistically significant difference. The results indicate that the specific immunotherapy is an effective treatment of seasonal allergic rhinitis with conjunctivitis in children sensitized to grass pollen.     

Sensitization to turnip rape and oilseed rape in children with atopic dermatitis: a case-control study

Turnip rape and oilseed rape 2S albumins are new allergens in children with atopic dermatitis suspected for food allergy. We recently found that 11% (206/1887) of these children had a positive skin prick test to seeds of oilseed rape ( Brassica napus ) and/or turnip rape ( Brassica rapa ). In the present case-control study we examined how the children with atopic dermatitis sensitized to turnip rape and oilseed rape had been breast-fed and whether they had some common sensitization pattern to certain foods or pollens. A total of 64 children with atopic dermatitis and a positive skin prick test to turnip rape and/or oilseed rape (≥5 mm) were examined. Sixty-four age- and sex-matched children with atopic dermatitis but negative skin prick tests to turnip rape and oilseed rape served as case controls. The turnip rape and/or oilseed rape sensitized children with atopic dermatitis had significantly more often positive skin prick tests reactions and IgE antibodies to various foods (cow's milk, egg, wheat, mustard; p < 0.01) and pollens (birch, timothy, mugwort; p < 0.01) than the control children. They had been exclusively breast-fed for a longer period (median 4 months; p < 0.05) and had more often associated asthma (36%) and allergic rhinitis (44%). Children with atopic dermatitis sensitized to oilseed rape and turnip rape had high frequency of associated sensitizations to all foods and pollens tested showing that oilseed plant sensitization affects especially atopic children who have been sensitized to multiple allergens.