Allergy is a disorder of the immune system in which the immune system responds to harmless substances, causing an allergic reaction. Early diagnosis and timely treatment can prevent possible future complications. It is essential that all adults caring for the child are aware of the disease and the therapeutic measures.
What is allergy?
Allergy is an alteration of the immune system. When an agent (bacteria, virus or foreign substance -different- to the organism) enters our body, there is a “fight” between the immune system and the invading agent. In the battle, the immune system synthesizes substances (antibodies) specialized in the destruction of that agent. This means that if we are attacked again in the future by the invading agent, it will be quickly destroyed by the antibodies.
Allergic diseases occur when, by mistake, our immune system gets confused, recognizes as harmful substances that are harmless and produces antibodies (IgE type) against them. These harmless substances to which our immune system responds by creating antibodies are called allergens. The main ones are: pollens of some plants, some foods and medicines, some molds, animal hairs and certain microscopic animals that feed on dust called dust mites.
When a person is sensitized to an allergen, every time he/she comes into contact with it, a “fight” takes place between the allergen and the antibody, resulting in an allergic reaction.
Atopy or hereditary predisposition to allergy
Allergic diseases have a lot to do with heredity. It is not an allergic disease that is inherited, but the predisposition to contract it. This genetic predisposition is called Atopy. Therefore, an atopic child is a child born with a genetic predisposition to suffer from allergic diseases. This child may remain for years, even a lifetime, without any allergic disease. However, others may debut with allergic manifestations from the first days of life.
Atopic patients are often characterized by skin and mucous membranes (skin covering the internal organs) that are overly reactive to non-specific irritants: pollution, insect bites, viral infections, etc.
Diagnosis of allergic diseases
Asthma, rhinitis, atopic dermatitis, urticaria, etc. are not always triggered by an allergic mechanism. It is very important, therefore, a correct diagnosis in children who suffer from them. It is up to the pediatrician to direct such diagnosis and to decide when an allergological study is pertinent or not, which should always be performed by a specialist in Allergology.
In order to be able to ensure that a given disease is caused by an allergic problem, the physician must be able to detect, by various means, the presence in the child of the antibodies (IgE) produced by our body in response to contact with the allergen. The antibodies created are found in the blood, but they also bind to special cells in the skin and mucous membranes. The quickest and easiest way to detect antibodies is therefore allergy testing, which consists of applying the allergen to the skin, making a small incision or puncture, and waiting a few minutes. If there is inflammation around the inoculation site, this indicates the presence of antibodies and sensitization to the allergen.
There are also more sophisticated laboratory methods that allow the patient’s blood to be tested for antibodies directly. The presence of antibodies alone allows us to affirm that the child has been sensitized, but this does not mean that, in all cases, this sensitization is responsible for the disease suffered by the child. In case of doubt, the allergist resorts to tolerance or provocation tests, which consist of administering, in a controlled manner, the suspected allergen and verifying that the clinical response obtained corresponds to the patient’s disease. These provocation tests can be performed for food allergy as well as for drug or respiratory allergy. They have a certain risk, so it is always up to the allergist to evaluate the ideal moment when it is necessary to perform them.
Treatment of allergic diseases
The treatment of allergic diseases is very effective and is based on four fundamental pillars:
1) Preventive measures. First of all, the cause of the allergic pathology must be known in order to apply appropriate preventive measures: avoiding exposure to the allergen can reduce or even eliminate allergic symptoms.
2) Pharmacological treatment. Secondly, appropriate pharmacological treatment. At present there is a wide range of drugs capable of keeping most allergic pathologies under control. Any drug can cause adverse effects but, correctly indicated and administered, the drugs available today are, fortunately, very effective and safe.
3) Immunotherapy. Thirdly, immunotherapy or specific anti-allergic vaccination, the only therapeutic measure that has been shown to be effective in influencing the natural evolution of the disease. Like any other drug, it is not free of side effects, so it must always be prescribed and controlled by an allergist. It is indicated when the allergic disease is not adequately controlled, despite allergen avoidance measures and the administration of the most innocuous drugs.
4) Education and self-management. Fourth, education and self-management, based on the knowledge of the child’s disease. The type of allergy suffered, the appropriate preventive measures, as well as the correct management of the indicated treatment: inhalation techniques, circumstances in which it should be increased or eliminated, as well as the mode of action in case of worsening, should be known by means of a written report.
It is very important that the diagnosis of the disease suffered by the child and all the therapeutic measures aimed at its control are known not only by the child’s parents and pediatrician, but also by the teachers and any person who will be in charge of the child’s care (grandparents, excursions, etc.).
Allergy has different manifestations, the most frequent being rhinitis, asthma, urticaria, dermatitis, conjunctivitis, among others. It is of utmost importance to know the cause of the allergy in order to treat it adequately. Allergic diseases, although not all, have a high degree of cure if measures are applied to avoid or reduce exposure to the allergen/s and an adequate specific treatment is followed. The vast majority of them can be kept under control. To this end, the collaboration of all those who have contact with the child should be sought: health personnel, family members, teachers and educators, etc., without forgetting the patient himself. Therefore, self-medication should be avoided and, in case of doubt, the pediatrician and/or allergist should be consulted.