4091 The Role of Clinical Phenotype and Allergen Sensitization at 2 Years As Predictors of Atopic Disorders at 5 Years.

Saturday, 17 October 2015
Hall D1 Foyer (Floor 3) (Coex Convention Center)

Li Yuan Gabriella Nadine Lee, B.Sc. (Hons.) , Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore

Phaik Ling Quah, PhD , Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore

Evelyn Xiu Ling Loo, PhD , Singapore Institute of Clinical Sciences, Agency of Science, Technology and Research, Singapore, Singapore

I-Chun Kuo, PhD , Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore

Gerez Irvin, MD , Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore

Genevieve Llanora, MD , Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore

Yiong Huak Chan, PhD , Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

Marion Aw, MD , Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore

Lynette Shek, MBBS, MRCPCH , Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore

Bee Wah Lee, MD , Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

Introduction: From a birth cohort of at risk Asian infants, we prospectively investigated the role of early onset allergen sensitization and clinical phenotypes as risk factors for atopic disorders at the age of 5 years.

Methods: The study recruited 253 families with a history of allergic disease in a first degree relative from an antenatal clinic in Singapore. The children were followed prospectively to assess clinical outcomes and skin prick test was performed at 2 and 5 years of age.

Results: Clinical phenotype alone at 2 years of age was associated with increased risk of atopic disorders at 5 years. This risk was further increased by the presence of concomitant allergen sensitization (food and/or house dust mites).  For eczema, eczema alone at 2 years old increased the risk of eczema at 5 years (adjOR 7.1 95%CI: 1.8-27.8). This risk was further increased by the presence of allergen sensitization (adjOR 25.4, 95%CI: 4.7-138.5).  For wheeze, wheeze alone at year 2 increased the risk of wheeze at year 5 (adjOR 4.5 95%CI: 1.4-14.8) and this risk tripled with the concomitant presence of allergen sensitization and eczema (adjOR 13.9, 95%CI: 1.2-168.5). As rhinitis symptoms were not apparent at the age of 2 years, allergen sensitization alone at 2 years without the rhinitis phenotype increased the risk of rhinitis at 5 years (adjOR 5.6 95%CI: 1.1-29.2). However, the eczema phenotype at 2 years alone also increased the risk of rhinitis at 5 years (adjOR 6.8 95%CI: 2.0-23.1).

Conclusion: In this Asian birth cohort, the clinical phenotypes alone and with concomitant allergen sensitization were predictors of eczema and wheeze at 5 years.  Except for the rhinitis outcome, allergen sensitization alone at 2 years could not predict atopic clinical outcomes at 5 years.