Allergen-specific IgE sensitization spectrum in 4,166 children with allergic diseases at a county-level hospital in eastern China: a retrospective cross-sectional study.

OBJECTIVE

This study aimed to characterize the serum specific IgE sensitization spectrum in children with allergic diseases at a county-level tertiary hospital and to evaluate age-, sex-, and co-sensitization patterns.

METHODS

This single-center retrospective cross-sectional study included 4,166 children aged <18 years with allergic diseases who underwent serum specific IgE (sIgE) testing at the First People's Hospital of Taicang City between 2019 and 2024. Twenty allergens (10 inhalant and 10 ingested) were measured by enzyme immunoassay, with sensitization defined as sIgE ≥0.35 kU/L. Sensitization patterns by sex and age were assessed using χ 2/Fisher's exact tests and multivariable logistic regression, and co-sensitization was evaluated using the φ coefficient.

RESULTS

The overall sensitization rate was 75.85%, with higher positivity in boys than girls (77.46% vs. 73.49%, P = 0.004); polysensitization was present in 57.35% of children (33.20%, 65.80%, and 56.99% in the <3, 3 to <12, and 12 to <18 years groups, respectively). The most common allergens were egg, Dermatophagoides farinae, house dust, Dermatophagoides pteronyssinus, and cow's milk. Sensitization showed a clear age-related shift from food allergens in children <3 years to inhalant allergens in adolescents. Male sex independently increased the risk of overall sensitization (aOR 1.26, 95% CI 1.09-1.46). Sensitization to mites and cat epithelium increased with age, whereas sensitization to egg and cow's milk declined. Co-sensitization analysis identified a strong mite cluster (D. farinae and D. pteronyssinus, φ = 0.888), a mite-related house-dust cluster, and a moderate early-food cluster involving egg, cow's milk, and wheat flour.

CONCLUSION

In this county-level cohort from the northern Yangtze River Delta, pediatric allergen sensitization was dominated by house dust mites and early food allergens, with sex- and age-related differences and distinct co-sensitization patterns. These findings may inform allergen screening and pediatric allergy management in similar regional settings.