Prevalence of allergy in patients with severe motor and intellectual disabilities (SMID)

BACKGROUND: Recent advances in medical care have drastically improved life prognosis of severe life-threatening diseases in newborns and young children. However, 'intact' survival without sequelae for all the children is still to be achieved and prevalence of severe motor and intellectual disabilities (SMID) secondary to central nervous system damages of any cause in childhood, especially in neonatal period, is increasing. Patients with SMID have complex problems involving multiple organs and multidisciplinary approach is mandatory. However, prevalence of allergic diseases in SMID patients is not known. METHODS: Forty one patients who were institutionalized and 26 outpatients at Mie National Hospital with SMID were enrolled. Diagnosis of allergic diseases was determined based on guidelines for the institutionalized patients and on a questionnaire asking if he/she had ever been diagnosed as the allergic diseases by any physician for outpatients. Serum total IgE, specific IgE to common allergens, eosinophil number, and exhaled nitric oxide by on-line tidal breathing method were measured. RESULTS: Lifetime prevalence of bronchial asthma, atopic dermatitis, food allergy, allergic rhinitis, allergic conjunctivitis, and drug allergy were 13.4%, 3.0%, 3.0%, 23.9%, 10.4%, and 6.0%, respectively. The sensitizations to Japanese cedar pollen, cypress, orchard grass, and ragweed were significantly more prevalent in outpatients compared with institutionalized patients. The prevalence of allergic rhinitis and allergic conjunctivitis are higher in outpatients compared with institutionalized patients (61.5% vs 0%, 23.1% vs 2.4%, respectively, p< 0.05). Exhaled nitric oxide levels in subjects who were diagnosed as asthma were significantly higher than in non-asthma. CONCLUSIONS: Allergic diseases are as common in SMID patients as general population. Further study is necessary to establish proper management for the patients.