Allergic diseases in early childhood and their association with migraine: a large-scale retrospective study

Introduction – Migraine is a common pediatric neurological disorder, and its relationship with allergic disease in early childhood remains incompletely defined. Objective – To explore the prevalence and distribution of allergic disorders among children with migraine. Methods – The electronic medical records from a large Health Maintenance Organization were searched, spanning from 2000 to 2023, for children from birth to 5 years of age diagnosed with allergic diseases who were diagnosed with migraine at age 5–18 years. Demographic characteristics and allergic comorbidities were analyzed and compared between children with migraine with and without allergic disease. Results – Among 6, 839 children with migraine, 2, 216 (32.4%) had at least one allergic comorbidity. Children with allergic disease presented at a younger age than those without allergies (median age 3 vs. 4 years, p < 0.001). Asthma was the only allergic disease that demonstrated a significant sex difference, being more common in males (p = 0.011). High socioeconomic status was the most common category in most allergic diseases, except for asthma. Atopic dermatitis was the most common allergic condition (41.7%), and multimorbidity was uncommon. Conclusions – This study demonstrates that allergic diseases in early childhood are associated with younger age at migraine diagnosis and with distinct demographic patterns. The distribution of allergic phenotypes in early-life observed in the cohort may play a role in migraine susceptibility. Future research should explore the mechanistic pathways linking early-childhood atopy and migraine and evaluate whether targeted management of allergic diseases can modify migraine outcomes in children.