European Journal of Pediatrics

, Volume 177, Issue 9, pp 1317–1325 | Cite as

Dynamics of allergy development during the first 5 years of life

  • Marketa Vrbova
  • Petra Dorociakova
  • Roman Vyskovsky
  • Lubica Palkovicova Murinova
  • Peter Ciznar
  • Katarina Rausova
  • Scott J. N. McNabb
  • Eva Reichrtova
  • Eva Budinska
  • Vojtech ThonEmail author
Original Article


Allergic diseases have increased in developed countries during the past decades. A cohort of Slovak children was followed from birth to track allergic symptoms dynamics in early childhood. Information on allergic symptoms (atopic dermatitis = AD, rhino conjunctivitis = RC, wheezing = Wh, urticaria = Ur) and food allergies among children was based on clinical evaluation of children by allergists at three developmental stages (infant, toddler, preschool). Out of 320 cases of allergies, 64 infants, 145 toddlers, and 195 preschool children suffered from AD, RC, Wh, Ur, or their combinations (i.e., significant increase with age, p < 0.001). AD first appeared in infants, Wh and/or RC rose mainly in toddlers, and Ur among preschool children. AD in infants or toddlers disappeared in the subsequent developmental stage in approximately one third of all cases. Single AD persistence without remission or extension was not common and accounted only for 6.9% of AD infants’ allergic manifestations. In addition to single-symptom allergic diseases, this study also identified several combinations of atopic symptoms.

Conclusions: The proportion of multi-symptom allergies increased while single-symptom forms decreased. The observed temporal trends of allergic symptoms correspond to the atopic march.

What is Known:

• The observed temporal trends of allergic symptoms correspond to the atopic march.

What is New:

• Allergic diseases in children were first manifested as single forms, with atopic dermatitis (AD) commonly functioning as the “entry point” to allergies.

• The overall proportion of single-symptom allergic disorders decreased over time while the proportion of multi-symptom allergies increased.


Allergy Asthma Atopic dermatitis Atopic march Questionnaire Rhino conjunctivitis 



Atopic dermatitis


Food allergy


Rhino conjunctivitis







We gratefully acknowledge the participation of all children, parents, pediatricians, and allergists at the clinics in the Slovak Republic.

Authors’ contributions

MV: main author of the manuscript

PD: statistical processing of the data

RV: statistical analyses, graphs preparation

LPM: study realization and data collection

PC: study preparation and data collection supervisor, professional guarantee in allergy

KR: study realization and data collection

SM: study preparation and data collection supervisor, professional guarantee in epidemiology

ER: study realization and data collection

EB: statistical analyses, graphs and manuscript preparation

VT: data interpretation and manuscript preparation, professional guarantee in allergy


The study was supported by the Agency for International Science and Technology Cooperation, US–SR Science and Technology Program, Grant No. 012/95, project of the National Health Promotion Program no. 23 and by Ministry of Education Youth and Sports the Czech Republic (LM2015051 and CZ.02.1.01/0.0/0.0/15_003/0000469).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

This study was done with the approval of the Institutional Review Boards of the Institute of Preventive and Clinical Medicine, Slovak Republic and the Centre’s for Disease Control and Prevention in Atlanta, GA, USA. All procedures respected ethical standards established by the Declaration of Helsinki.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Marketa Vrbova
    • 1
    • 2
    • 3
  • Petra Dorociakova
    • 1
  • Roman Vyskovsky
    • 1
    • 4
  • Lubica Palkovicova Murinova
    • 5
  • Peter Ciznar
    • 6
  • Katarina Rausova
    • 5
  • Scott J. N. McNabb
    • 7
  • Eva Reichrtova
    • 5
  • Eva Budinska
    • 1
  • Vojtech Thon
    • 1
    • 3
    Email author
  1. 1.Research Centre for Toxic Compounds in the Environment, Faculty of ScienceMasaryk UniversityBrnoCzech Republic
  2. 2.Department of Internal Gastroenterology, Faculty of MedicineMasaryk University, University Hospital BrnoBrnoCzech Republic
  3. 3.Department of Clinical Immunology and Allergy, Faculty of MedicineMasaryk University, St. Anne’s University HospitalBrnoCzech Republic
  4. 4.Institute of Biostatistics and Analyses, Faculty of MedicineMasaryk UniversityBrnoCzech Republic
  5. 5.Department of Environmental Medicine, Faculty of Public HealthSlovak Medical University in BratislavaBratislavaSlovak Republic
  6. 6.1st Department of Pediatrics, Faculty of MedicineComenius UniversityBratislavaSlovakia
  7. 7.Department of Epidemiology and Biostatistics, College of Public Health and Health InformaticsEmory UniversityAtlantaUSA

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