Clinical and anamnestic characteristics and results of allergological testing in children with bronchial asthma and allergic rhinitis in case of allergy to house dust mites


Volume 66 • Issue 3 • September 2021, pp. 40-48

Received: 03.09.2021 | Publication date: 30.09.2021

O.V. Trusova, A.V. Kamaev, N.L. Lyashenko, I.V. Makarova

Pavlov University St. Petersburg, Russia

Full text PDF (rus)

House dust mites (HDM) are a common cause of allergies, however, it is not always easy to suspect a mite allergy from a patient’s history. Objective: to determine clinical characteristics of patients, tactics for demonstrating the role of HDM sensitization in pediatric patients with allergic rhinitis (AR) and bronchial asthma (BA) with domestic sensitization. Materials and methods. The study included 420 patients, 256 boys, 164 girls, aged 5 to 17,9 years (mean 8,44 ± 3,06 years), with AR (100%) and AR in combination with BA (41,9%). The prick test on the forearm skin with water-soluble extracts was carried out and evaluated according to the standard method. The test was considered positive with a maximum wheal diameter of ≥3 mm 15 minutes after applying the prick. Results. Among patients with HDM sensitization (n=268), sensitization to both mites was detected in 218 cases (81,3%), and in 139 cases (51,9%) polysensitization to HDM allergens, house dust and epidermal allergens (cat, dog) was found. Patients noted persistent symptoms of nasal congestion, and rhinorrhea; the provoking factor was not determined by history in 46% of cases. In 69,8% of cases (97 children), it was impossible to isolate the leading allergen according to the history, since patients had contact with cats, dogs, dust, and polysensitization according to the prick tests. Nasal provocation test (NPT) with HDM allergens was performed in 92 children. Positive NPT was obtained in 83 cases (90,2%), negative in 9 cases (9,8%). Conclusions. With HDM sensitization, often (46%) the provoking factor is not determined by history. Monotonous symptoms are characteristic with the absence of obvious relationships with allergens, the location and activities of the child. In terms of frequency, the leading variant is sensitization to both mites D.pteronyssinus, D.farinae (81,3%), and polysensitization to HDM, house dust and cat and dog allergens (51,9%). NPT allows in 90% of cases to show the causal role of HDM allergens in polysensitized patients with insufficiently convincing anamnesis data.


1. Thomas W.R, Smith W. House-dust-mite allergens. Allergy. 1998; 53: 821–832. doi: 10.1111/j.1398-9995.1998.tb03987.x.

2. Calderón M.A, Linneberg A., Kleine-Tebbe J., De Blay F., Hernandez Fernandez de Rojas D., Virchow J.C., Demoly P. Respiratory allergy caused by house dust mites: What do we really know?. J. Allergy Clin. Immunol. 2015; 136: 38–48. doi: 10.1016/j.jaci.2014.10.012.

3. Posa D., Perna S., Resch Y., Lupinek C., Panetta V., Hofmaier S. Evolution and predictive value of IgE responses toward a comprehensive panel of house dust mite allergens during the first 2 decades of life. J. Allergy Clin. Immunol. 2017; 139: 541–549. doi: 10.1016/j.jaci.2016.08.014.

4. Bauchau V., Durham S.R. Prevalence and rate of diagnosis of allergic rhinitis in Europe. European Respiratory Journal. 2004; 24: 758–764. doi: 10.1183/09031936.04.00013904.

5. Platts-Mills T.A.E., de Weck A.L., Aalberse R.C., Bessot J.C., Bjorksten B, Bischoff E. Dust mite allergens and asthma — a worldwide problem. J. Allergy Clin. Immunol. 1989; 83: 416–427. doi: 10.1016/0091-6749(89)90128-0.

6. Трусова О.В., Камаев А.В., Ляшенко Н.Л., Макарова И.В., Столярова Е.А. Сенсибилизация к бытовым аллергенам у детей с бронхиальной астмой и аллергическим ринитом в г. Санкт-Петербурге. Аллергология и иммунология в педиатрии. 2021; 2 (65): 11–18. [Trusova O.V., Kamaev A.V., Lyashenko N.L., Makarova I.V., Stolyarova E.A. Sensitization to household allergens in children with bronchial asthma and allergic rhinitis in St. Petersburg. Allergologiya i immunologiya v pediatrii. 2021; 2 (65): 11–18. (In Russ.)]

7. Feng B., Xiang H., Jin H., Gao J., Huang S., Shi Y., Chen R., Chen B. Efficacy of Sublingual Immunotherapy for House Dust Mite-Induced Allergic Rhinitis: A Meta-Analysis of Randomized Controlled Trials. Allergy Asthma Immunol. Res. 2017; 9: 220–228. doi: 10.4168/aair.2017.9.3.220.

8. Roberts G., Pfaar O., Akdis C.A., Ansotegui I.J., Durham S.R., Gerth van Wijk R. EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis. Allergy. 2017; 00: 1–33. doi: 10.1111/all.13317.

9. Alvaro-Lozano M., Akdis C.A., Akdis M., Alviani C., Angier E., Arasi S., Arzt-Gradwohl L., Barber D., Bazire R., Cavkaytar O., Comberiati P., Dramburg S., Durham S.R., Eifan A.O., Forchert L., Halken S., Kirtland M., Kucuksezer U.C., Layhadi J.A., Matricardi P.M., Muraro A., Ozdemir C., Pajno G.B., Pfaar O., Potapova E., Riggioni C., Roberts G., Rodrıguez del Rio P., Shamji M.H., Sturm G.J., Vazquez-Ortiz M. EAACI Allergen Immunotherapy User’s Guide. Pediatr. Allergy Immunol. 2020; 31 (Suppl. 25): 1–101. doi: 10.1111/pai.13189.

10. Demoly P., Matucci A., Rossi O., Vidal C. A year-long, fortnightly, observational survey in three European countries of patients with respiratory allergies induced by house dust mites: Methodology, demographics and clinical characteristics. BMC Pulm. Med. 2016; 6: 85. doi: 10.1186/s12890-016-0246-9.

11. Matricardi P.M., Kleine-Tebbe J., Hoffmann H.J., Valenta R., Hilger C., Hofmaier S. EAACI Molecular Allergology User’s Guide. Pediatr. Allergy Immunol. 2016; 27 (suppl.23): 1–250. doi: 10.1111/pai.12563.

12. Burbach G.J., Heinzerling L.M., Edenharter G., Bachert C., Bindslev-Jensen C., Bonini S., Bousquet J., Bousquet-Rouanet L., Bousquet P.J., Bresciani M., Bruno A., Canonica G.W., Darsow U., Demoly P., Durham S., Fokkens W.J., Giavi S., Gjomarkaj M., Gramiccioni C., Haahtela T., Kowalski M.L., Magyar P., Muraközi G., Orosz M., Papadopoulos N.G., Röhnelt C., Stingl G., Todo-Bom A., Von Mutius E., Wiesner A., Wöhrl S., Zuberbier T. GA2LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe. Allergy. 2009; 64: 1507–1515. doi:10.1111/j.1398-9995.2009.02089.x.

13. Haahtela T., Laatikainen T., Alenius H., Auvinen P., Fyhrquist N., Hanski I., von Hertzen L., Jousilahti P., Kosunen T. U., Markelova O., Mäkelä M. J., Pantelejev V., Uhanov M., Zilber E., Vartiainen E. Hunt for the origin of allergy — comparing the Finnish and Russian Karelia. Clin. Exp. Allergy. 2015; 45: 891–901. doi: 10.1111/cea.12527.

14. Bousquet J., Anto J.M., Bachert C., Bousquet P.J., Colombo P., Crameri R., Daëron M., Fokkens W., Leynaert B., Lahoz C., Maurer M., Passalacqua G., Valenta R., Van Hage M., Van Ree R. Factors responsible for differences between asymptomatic subjects and patients presenting an IgE sensitization to allergens. A GA2LEN project. Allergy. 2006; 61: 671–680. doi: 10.1111/j.1398-9995.2006.01048.x.

15. Bodtger U., Assing K., Poulsen L. A Prospective, Clinical Study on Asymptomatic Sensitisation and Development of Allergic Rhinitis: High Negative Predictive Value of Allergological Testing. Int. Arch. Allergy Immunol. 2011; 155: 289–296. doi: 10.1159/000320758.

16. Hong S.N., Rhee C.S., Kim J.K. Clinical characteristics of asymptomatic allergen sensitization with nasal septal deviation, often misdiagnosed as allergic rhinitis. Eur Arch Otorhinolaryngol. 2021; (in press.). doi: 10.1007/s00405-021-06725-5.

17. Национальная программа «Бронхиальная астма у детей. Стратегия и профилактика». Москва, 2017. [Nacional’naja programma «Bronhial’naja astma u detej. Strategija i profilaktika». Moskva, 2017. (In Russ.)]

18. Bousquet J., Heinzerling L., Bachert C. [et al.]. Practical guide to skin prick tests in allergy to aeroallergens.Allergy. 2012; 67: 18–24. doi: 10.1111/j.1398-9995.2011.02728.x.

19. Трусова О.В., Камаев А.В., Ляшенко Н.Л., Макарова И.В. Эндоназальная провокационная проба с аллергенами клещей домашней пыли у детей с бронхиальной астмой и аллергическим ринитом: вопросы методики и безопасности. Аллергология и иммунология в педиатрии. 2020, 62: 15–22. doi: 10.24411/2500-1175-2020-10008. [Trusova O.V., Kamaev A.V., Lyashenko N.L., Makarova I.V. Method and safety of nasal allergen provocational test with house dust mite allergen in children with bronchial asthma and allergic rhinitis. Allergologiya i immunologiya v pediatrii. 2020; 62: 15–22. (In Russ.)]

20. Arasi S., Pajno G.B., Panasiti I., Sandoval M., Alvaro-Lozano M. Allergen Immunotherapy in children with respiratory allergic diseases. Minerva Pediatr. 2020; 72: 343–357. doi: 10.23736/S0026-4946.20.05959-9.

21. Agache I., Lau S., Akdis C.A., Smolinska S., Bonini M., Cavkaytar O. EAACI Guidelines on Allergen Immunotherapy: House dust mite-driven allergic asthma. Allergy. 2019; 74: 855– 873. doi: 10.1111/all.13749.


Trusova OV, Kamaev AV, Lyashenko NL, Makarova IV. Clinical and anamnestic characteristics and results of allergological testing in children with bronchial asthma and allergic rhinitis in case of allergy to house dust mites. Allergology and Immunology in Pediatrics. 2021;3(66):40–48. (In Russ.)

For correspondence:

Olga V. Trusova

PhD, assistant professor, department of Therapy with the course on allergy and immunology, Pavlov University

ORCID logo   0000-0002-0854-1536
map marker alt icon   6-8, L’va Tolstogo Street, 197022, St. Petersburg, Russia
smt1 email icon

Supporting agencies:

Not specified


Not specified


Spelling error report

The following text will be sent to our editors: