Cat and Dog Sensitisation Patterns and Clinical Relevance in a Belgian Paediatric Cohort
(2026) Acta Paediatrica — Vol. 115, n° 6, p. 1301-1304 (2026)
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- Respiratory allergies, including pet allergies, are increasing worldwide, with clinical manifestations (rhinoconjunctivitis, asthma or anaphylaxis) ranging from mild to severe forms [1]. The impact of pet exposure remains debated: early-life contact may either promote sensitisation or induce tolerance, a balance influenced by the timing, duration and intensity of exposure [2]. Moreover, pet allergens are easily dispersed in indoor environments , leading to substantial indirect exposure [3]. In this context, we recently reported paediatric aeroallergen sensitisa-tion profiles in Southern Belgium, wherein cat (31.1%) and dog (24.2%) sensitisations represented a significant proportion of cases after house dust mites (HDM) and pollens. Building upon these findings, this multicentre Belgian retrospective study aimed to assess the patterns and clinical relevance of pet sensitisation, as well as the implementation of avoidance measures. This secondary analysis of a previously described co-hort [4] included only pet-sensitised children who underwent skin prick tests (SPT) for suspected aeroallergen-related manifestations in 2023 across seven hospitals in Southern Belgium. Ethics approval was obtained from all participating centres, with informed consent waived. Clinical data, SPT results, pet ownership and avoidance measures were extracted and centrally reviewed by a single investigator. Reported symptoms included rhinoconjunctival (itchy or watery eyes, sneezing, nasal congestion or pruritus), respiratory (cough, wheezing, dyspnoea) and dermatological manifestations (eczema, urticaria, erythema). Sensitisation was clinically relevant if ≥ 1 symptoms occurred upon exposure to the sensi-tising animal. SPT procedures were performed using standardised aeroal-lergen extracts, with histamine (10 mg/mL) and 0.9% saline as positive and negative controls, respectively, and a positive test defined as a mean wheal diameter ≥ 3 mm greater than the negative control [4]. Tested aeroallergens included Betulaceae, grass and weed pollens, moulds, HDM and pet dander (cat, dog). Exclusion criteria comprised: inadequate antihistamine wash-out, absent histamine response or positive saline control, testing performed unrelated to aeroallergy. Categorical variables were compared using χ 2 test. Among the 1522 aeroallergen sensitised-children, 615 (40.4%) showed pet sensitisation. The prevalence of pet sensitisation increased with age and reached a plateau around 9-10 years, par-alleling the overall rise in aeroallergen sensitisation [4]. Within this pet-sensitised cohort, 6.0% were exclusively sensitised to cats, 4.1% exclusively to dogs and 1.8% to pets only, while most children (88.1%) were polysensitised to at least one pet and another aeroallergen ('pet + other' group). The most frequent co-sensitisations were HDM, grass and Betulaceae pollen (Table 1). Clinically, respiratory symptoms were more common (68.1%), followed by rhinoconjunctivitis (47.0%), whereas dermatological complaints were rare (4.4%). Clinical relevance differed significantly between sensitisation patterns, with pet-only sensitisation associated with a higher likelihood of clinically relevant symptoms compared with pet+other sensitisation (p = 0.013; OR: 1.9; 95% CI: 1.1-3.3) (Figure 1). Among children with clinically relevant symptoms (n = 245), avoidance measures were implemented in 34.5% of cases and did not differ significantly between the pet-only and pet+other groups (25.0% vs.
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Stavart, C., Thimmesch, M., De Saint‐moulin, T., Goubau, C., & Bodart, E. (2026). Cat and Dog Sensitisation Patterns and Clinical Relevance in a Belgian Paediatric Cohort. Acta Paediatrica, 115(6), 1301-1304. https://doi.org/10.1111/apa.70482 (Original work published 2026)