Summary. One
hundred consecutive
asthmatic paediatric
patients were
evaluated and skin
tested with a
battery of skin
prick test reagents,
including 8
different
standardized house
dust mite extracts.
Asthma severity was
graded according to
the Global
Initiative for
Asthma (GINA)
document in mild
persistent (52
patients), moderate
persistent (39) and
severe persistent
(9). Sixty patients
had asthma and
allergic rhinitis,
12 asthma and
eczema, and 8 asthma,
allergic rhinitis
and eczema. The
patient population
was divided into 2
different
socioeconomic groups
(50 patients per
group) based on a
standardized,
validated
questionnaire. A
dust sample was
collected with an
adapted vacuum
cleaner from the
mattress of each
patient and analysed
for Der p 1, Der f 1
and Der p 2 allergen
content using
monoclonal
antibodies.
Eighty patients were
skin test positive
to at least one mite
species. All
positive skin test
patients were
positive to
Dermatophagoides
pteronyssinus, 99%
to D. farinae, 92%
to Euroglyphus
maynei, 80% to
Lepidoglyphus
destructor, 73% to
Tyrophagus
putrescientae, 72%
to Blomia tropicalis;
70% to Acarus siro
and 68% to
Chortoglyphus
arcuatus. All
patients with severe
persistent asthma
had a positive skin
test to mites, 85%
in the moderate
group, and 73% in
the mild group
(p<0.01). 95% of
patients with asthma
and allergic
rhinitis had a
positive skin test
to mites, 92% of
patients with asthma
and eczema and 100%
of patients with
asthma, allergic
rhinitis and eczema;
(p<0.01). Mean Der p
1, Der f 1 and Der p
2 allergen
concentrations were
18.3, 0.6 and 5.6 µg/g
of mattress dust,
respectively. Mean
Der p 1 allergen
levels in the middle-low
socioeconomic group
were significantly
higher than in the
middle high group (p
< 0.01).
There is a high rate
of allergic
sensitisation among
pediatric asthmatic
patients in Chile.
More than one
species are
implicated, although
sensitisation and
exposure to D.
pteronyssinus
predominates. Mite
allergic patients
are exposed to high
mite allergen
concentrations,
exceeding previously
established risk
levels for
sensitisation and
symptoms.
Key words:
asthma, mites,
Dermatophagoides,
allergen levels,
dust sample. |