D2.485 - Comprehensive Understanding of the Characteristics of Pediatric Pollen Allergy Patients

Climatic shifts are altering pollen exposure patterns globally, yet real-world clinical data on pediatric pollen allergy remain limited. This study aimed to characterize clinical features, sensitization profiles, and comorbidities among children with pollen allergy.

We analyzed 485 pediatric patients with pollen allergy at Yongin Severance Hospital. Pollen allergy in children was defined by compatible clinical symptoms plus at least one of the following: (1) a positive skin prick test (wheal ≥3 mm compared with the negative control), (2) serum allergen-specific IgE ≥0.35 kU/L, or (3) MAST class ≥3, in the presence of compatible clinical symptoms. 

Allergic rhinitis was the most prevalent comorbidity (95.3%), followed by asthma (28.5%), atopic dermatitis (25.8%), food allergy (17.7%), and conjunctivitis (16.7%). Alder was the dominant sensitizer, identified in 99.8% of patients. Oral allergy syndrome (OAS) was present in 4.7% (n=23), with apple being the most common trigger (78.3%). Compared to OAS-negative patients, the OAS-positive group exhibited significantly higher rates of food allergy (78.3% vs. 14.7%, p < 0.001), allergic conjunctivitis (34.8% vs. 15.8%, p = 0.017), and atopic dermatitis (43.5% vs. 24.9%, p = 0.047), alongside a trend toward higher total IgE levels. 

Pediatric pollen allergy is characterized by high rates of multimorbidity, with Alder as a predominant sensitizer. Although relatively infrequent, OAS serves as a clinical marker for a high-risk phenotype enriched for food allergy and ocular/skin comorbidities. Integrated management of the rhinitis–asthma–dermatitis triad and routine OAS screening are essential for these patients, particularly under changing climatic conditions.