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Point Prevalence, Risk Factors and Useful Parameters for Food Allergy in Children with Atopic Dermatitis

Year 2021, Volume: 8 Issue: 2, 84 - 90, 31.08.2021

Abstract

No consensus has yet been reached on the presence and prevalence of food allergy (FA) in children with atopic dermatitis (AD). To investigate the incidence of FA accompanying AD in preschool children and to determine the parameters that can be used to predict this association. This case-control study is a retrospective analysis of 401 children aged 0-6 years with AD who had a SCORAD index of >15 between 2017-2020 at our university hospital. Children were subgrouped regarding the age of onset of AD (subgroup I: <24 months, subgroup II: ≥ 24 months). The sociodemographic characteristics and allergological test results were studied. Food allergy prevalence of patients with AD to at least one food was 23.6% (n=95). Gender, age of the child, and age of onset of AD increase in BEC were the independent risk factors (p=0.047; 0.004; 0.014 and p=0.012, respectively). Time to start complementary feeding, degree of kinship, and serum specific IgE milk positivity were independent risk factors for study subgroup I (p=0.045, 0.187, 0.019, respectively). In predicting FA in subgroup I, the cut-off point for BEC was 525 K/mm3, and the BEC/WBCs ratio was 0.0522 (73.91% sensitivity, 63.64% specificity). The risk factors and in-vitro parameters determined can guide physicians in predicting the concomitant FA in children with AD.

Supporting Institution

I have no funding source

Project Number

Project/Decision no: 19/412; Meeting no: 2019/18

Thanks

My special thanks to [Naci Murat, Assoc. Prof.] for assistance in performing the statistical analysis of the research data. I am also grateful to [Ozlem Ezgingil, Nurse], who served with love for our patients.

References

  • 1. Roduit C, Frei R, Depner M, et al. Phenotypes of Atopic Dermatitis Depending on the Timing of Onset and Progression in Childhood. JAMA Pediatr. 2017;1;171: 655-62.
  • 2. Du Toit G, Santos A, Roberts G, et al. The diagnosis of IgE-mediated food allergy in childhood. Pediatr Allergy Immunol. 2009;20:309–19.
  • 3. Mastrorilli C, Caffarelli C, Hoffmann-Sommergruber K. Food allergy and atopic dermatitis: Prediction, progression, and prevention. Pediatr Allergy Immunol. 2017;28:831–40.
  • 4. Portelli MA, Hodge E, Sayers I. Genetic risk factors for the development of allergic disease identified by genome-wide association. Clin Exp Allergy.2015;45:21–31.
  • 5. Lockett GA, Huoman J, Holloway JW. Does allergy begin in utero? Pediatr Allergy Immunol. 2015;26:394–2. 6. Rowlands D, Tofte SJ, Hanifin JM. Does food allergy cause atopic dermatitis? Food challenge testing to dissociate eczematous from immediate reactions. Dermatol Ther. 2006;19:97-3.
  • 7. Suh KY. Food allergy and atopic dermatitis: separating fact from fiction. Semin Cutan Med Surg. 2010;29:72-8.
  • 8. 8.Werfel T, Ballmer-Weber B, Eigenmann PA, et al. Eczematous reactions to food in atopic eczema: position paper of the EAACI and GA2LEN. Allergy. 2007;62:723-28.
  • 9. Gray CL, Levin ME, Zar HJ, Potter PC, et al. Food allergy in South African children with atopic dermatitis. Pediatr Allergy Immunol. 2014 ;25:572-79.
  • 10. Burks AW, James JM, Hiegel A, et al. Atopic dermatitis and food hypersensitivity reactions. J Pediatr. 1998;132:132-36.
  • 11. Sampson HA, McCaskill CC. Food hypersensitivity and atopic dermatitis: evaluation of 113 patients. J Pediatr. 1985;107:669–75.
  • 12. Eigenmann PA, Calza AM. Diagnosis of IgE-mediated food allergy among Swiss children with atopic dermatitis. Pediatr Allergy Immunol. 2000;11:95–0.
  • 13. García C, El-Qutob D, Martorell A, et al. Sensitization in early age to food allergens in children with atopic dermatitis. Allergol Immunopathol (Madr). 2007;35:15-0.
  • 14. Bousquet J, Heinzerling L, Bachert C, et al. Global Allergy and Asthma European Network; Allergic Rhinitis and its Impact on Asthma. Practical guide to skin prick tests in allergy to aeroallergens. Allergy. 2012;67:18-4.
  • 15. Nowak-Wegrzyn A, Assa'ad AH, Bahna SL, et al. Adverse Reactions to Food Committee of American Academy of Allergy, Asthma &Immunology. Work Group report: oral food challenge testing. J Allergy Clin Immunol. 2009;123:365-83.
  • 16. 16.Bieber T, D'Erme AM, Akdis CA, et al. Clinical phenotypes and endophenotypes of atopic dermatitis: Where are we, and where should we go? J Allergy Clin Immunol. 2017;139:58-64.
  • 17. Schloss OM. Allergy to common foods. Trans Am Pediatr Soc. 1915;27:62-8.
  • 18. Greenhawt M. The role of food allergy in atopic dermatitis. Allergy Asthma Proc. 2010;31:392-97.
  • 19. 1Rancé F. Food allergy in children suffering from atopic eczema. Pediatr Allergy Immunol. 2008;19:279-84.
  • 20. Uenishi T, Sugiura H, Tanaka T, et al. Role of foods in irregular aggravation of skin lesions in children with atopic dermatitis. J Dermatol. 2008;35:407-12.
  • 21. Dharma C, Lefebvre DL, Tran MM, et al. Patterns of allergic sensitization and atopic dermatitis from 1 to 3 years: Effects on allergic diseases. Clin Exp Allergy. 2018;48:48-59.
  • 22. Beken B, Celik V, Gokmirza Ozdemir P, et al. Food Sensitization and Food Allergy in Atopic Dermatitis. Osmangazi J Med. 2019;41:405-12.
  • 23. Mailhol C, Giordano-Labadie F, Lauwers-Cances V, et al. Point prevalence and risk factors for food allergy in a cohort of 386 children with atopic dermatitis attending a multidisciplinary dermatology/paediatric allergy clinic. Eur J Dermatol. 2014;24:63–9.
  • 24. Noh G, Jin H, Lee J, et al.Eosinophilia as a predictor of food allergy in atopic dermatitis. Allergy Asthma Proc. 2010;31:18–24.
  • 25. Henderson J, Northstone K, Lee SP, et al. The burden of disease associated with filaggrin mutations: a population-based, longitudinal birth cohort study. J Allergy Clin Immunol. 2008;121:872-7.
  • 26. Barker JN, Palmer CN, Zhao Y, et al. Null mutations in the filaggrin gene (FLG) determine major susceptibility to early-onset atopic dermatitis that persists into adulthood. J Invest Dermatol. 2007;127:564-67.
  • 27. Brown SJ, Asai Y, Cordell HJ, et al. Loss-of-function variants in the filaggrin gene are a significant risk factor for peanut allergy. J Allergy Clin Immunol. 2011;127:661-67.
  • 28. Spergel JM, Boguniewicz M, Schneider L, et al. Food Allergy in Infants With Atopic Dermatitis: Limitations of Food-Specific IgE Measurements. Pediatrics. 2015;136:1530–8.
  • 29. Burks AW, Jones SM, Boyce JA, et al. NIAID-sponsored 2010 guidelines for managing food allergy: applications in the pediatric population. Pediatrics. 2011;128:955-65.
  • 30. Federly TJ, Jones BL, Dai H, et al. Interpretation of food specific immunoglobulin E levels in the context of total IgE. Ann Allergy Asthma Immunol. 2013;111:20–4.

Atopik Dermatitli Çocuklardaki Besin Alerjisini Tahminde Kullanılabilecek Parametreler ve Risk Faktörleri, Nokta Prevalans

Year 2021, Volume: 8 Issue: 2, 84 - 90, 31.08.2021

Abstract

Atopik dermatit’li çocuklarda besin alerjisi varlığı ve yaygınlığı konusunda fikir birliğine varılamamıştır. Çalışmamızda, okul öncesi çocuklarda atopik dermatit’e eşlik eden besin alerjisi insidansını araştırmak ve bu ilişkiyi tahmin etmede kullanılabilecek parametreleri belirlemeyi amaçladık. Bu vaka-kontrol çalışması, üniversite hastanemizde 2017-2020 yılları arasında SCORAD indeksi >15 olan, 0-6 yaş arası AD'li toplam 401 çocuğun retrospektif bir incelemesidir. Araştırmaya dahil edilen çocukların sosyodemografik özellikleri ve alerji testleri incelenmiştir. Atopik dermatit’in başlangıç yaşına göre çocuklar iki alt gruba ayrılmıştır. (Alt grup I: <24 ay, Alt grup II: ≥24 ay).
Atopik dermatit’li hastaların en az bir yiyeceğe karşı besin alerjisi prevalansı %23.6 (n=95) idi. Cinsiyet, çocuğun yaşı, atopik dermatit başlangıç yaşı ve kan eozinofil sayısındaki (KES) artış bağımsız risk faktörleri olarak saptandı. (p-değerleri sırasıyla; 0.047, 0.004, 0.014 ve 0.012). Tamamlayıcı beslenmeye başlama zamanı, akrabalık derecesi ve serum süt spesifik IgE pozitifliği alt grup I için bağımsız risk faktörleriydi (p-değerleri sırasıyla; 0.045, 0.187, 0.019). Alt grup I'deki besin alerjisini tahmin etmede KES için kesme noktası 525 K/mm3 ve KES/WBC oranı 0.0522 idi (duyarlılık %73.91; özgüllük %63.64). Araştırmamızda belirlenen risk faktörleri ve in-vitro parametreler klinisyenlere AD'li çocuklarda eşlik eden besin alerjisini tahmin etmede yol gösterici olabilir.

Project Number

Project/Decision no: 19/412; Meeting no: 2019/18

References

  • 1. Roduit C, Frei R, Depner M, et al. Phenotypes of Atopic Dermatitis Depending on the Timing of Onset and Progression in Childhood. JAMA Pediatr. 2017;1;171: 655-62.
  • 2. Du Toit G, Santos A, Roberts G, et al. The diagnosis of IgE-mediated food allergy in childhood. Pediatr Allergy Immunol. 2009;20:309–19.
  • 3. Mastrorilli C, Caffarelli C, Hoffmann-Sommergruber K. Food allergy and atopic dermatitis: Prediction, progression, and prevention. Pediatr Allergy Immunol. 2017;28:831–40.
  • 4. Portelli MA, Hodge E, Sayers I. Genetic risk factors for the development of allergic disease identified by genome-wide association. Clin Exp Allergy.2015;45:21–31.
  • 5. Lockett GA, Huoman J, Holloway JW. Does allergy begin in utero? Pediatr Allergy Immunol. 2015;26:394–2. 6. Rowlands D, Tofte SJ, Hanifin JM. Does food allergy cause atopic dermatitis? Food challenge testing to dissociate eczematous from immediate reactions. Dermatol Ther. 2006;19:97-3.
  • 7. Suh KY. Food allergy and atopic dermatitis: separating fact from fiction. Semin Cutan Med Surg. 2010;29:72-8.
  • 8. 8.Werfel T, Ballmer-Weber B, Eigenmann PA, et al. Eczematous reactions to food in atopic eczema: position paper of the EAACI and GA2LEN. Allergy. 2007;62:723-28.
  • 9. Gray CL, Levin ME, Zar HJ, Potter PC, et al. Food allergy in South African children with atopic dermatitis. Pediatr Allergy Immunol. 2014 ;25:572-79.
  • 10. Burks AW, James JM, Hiegel A, et al. Atopic dermatitis and food hypersensitivity reactions. J Pediatr. 1998;132:132-36.
  • 11. Sampson HA, McCaskill CC. Food hypersensitivity and atopic dermatitis: evaluation of 113 patients. J Pediatr. 1985;107:669–75.
  • 12. Eigenmann PA, Calza AM. Diagnosis of IgE-mediated food allergy among Swiss children with atopic dermatitis. Pediatr Allergy Immunol. 2000;11:95–0.
  • 13. García C, El-Qutob D, Martorell A, et al. Sensitization in early age to food allergens in children with atopic dermatitis. Allergol Immunopathol (Madr). 2007;35:15-0.
  • 14. Bousquet J, Heinzerling L, Bachert C, et al. Global Allergy and Asthma European Network; Allergic Rhinitis and its Impact on Asthma. Practical guide to skin prick tests in allergy to aeroallergens. Allergy. 2012;67:18-4.
  • 15. Nowak-Wegrzyn A, Assa'ad AH, Bahna SL, et al. Adverse Reactions to Food Committee of American Academy of Allergy, Asthma &Immunology. Work Group report: oral food challenge testing. J Allergy Clin Immunol. 2009;123:365-83.
  • 16. 16.Bieber T, D'Erme AM, Akdis CA, et al. Clinical phenotypes and endophenotypes of atopic dermatitis: Where are we, and where should we go? J Allergy Clin Immunol. 2017;139:58-64.
  • 17. Schloss OM. Allergy to common foods. Trans Am Pediatr Soc. 1915;27:62-8.
  • 18. Greenhawt M. The role of food allergy in atopic dermatitis. Allergy Asthma Proc. 2010;31:392-97.
  • 19. 1Rancé F. Food allergy in children suffering from atopic eczema. Pediatr Allergy Immunol. 2008;19:279-84.
  • 20. Uenishi T, Sugiura H, Tanaka T, et al. Role of foods in irregular aggravation of skin lesions in children with atopic dermatitis. J Dermatol. 2008;35:407-12.
  • 21. Dharma C, Lefebvre DL, Tran MM, et al. Patterns of allergic sensitization and atopic dermatitis from 1 to 3 years: Effects on allergic diseases. Clin Exp Allergy. 2018;48:48-59.
  • 22. Beken B, Celik V, Gokmirza Ozdemir P, et al. Food Sensitization and Food Allergy in Atopic Dermatitis. Osmangazi J Med. 2019;41:405-12.
  • 23. Mailhol C, Giordano-Labadie F, Lauwers-Cances V, et al. Point prevalence and risk factors for food allergy in a cohort of 386 children with atopic dermatitis attending a multidisciplinary dermatology/paediatric allergy clinic. Eur J Dermatol. 2014;24:63–9.
  • 24. Noh G, Jin H, Lee J, et al.Eosinophilia as a predictor of food allergy in atopic dermatitis. Allergy Asthma Proc. 2010;31:18–24.
  • 25. Henderson J, Northstone K, Lee SP, et al. The burden of disease associated with filaggrin mutations: a population-based, longitudinal birth cohort study. J Allergy Clin Immunol. 2008;121:872-7.
  • 26. Barker JN, Palmer CN, Zhao Y, et al. Null mutations in the filaggrin gene (FLG) determine major susceptibility to early-onset atopic dermatitis that persists into adulthood. J Invest Dermatol. 2007;127:564-67.
  • 27. Brown SJ, Asai Y, Cordell HJ, et al. Loss-of-function variants in the filaggrin gene are a significant risk factor for peanut allergy. J Allergy Clin Immunol. 2011;127:661-67.
  • 28. Spergel JM, Boguniewicz M, Schneider L, et al. Food Allergy in Infants With Atopic Dermatitis: Limitations of Food-Specific IgE Measurements. Pediatrics. 2015;136:1530–8.
  • 29. Burks AW, Jones SM, Boyce JA, et al. NIAID-sponsored 2010 guidelines for managing food allergy: applications in the pediatric population. Pediatrics. 2011;128:955-65.
  • 30. Federly TJ, Jones BL, Dai H, et al. Interpretation of food specific immunoglobulin E levels in the context of total IgE. Ann Allergy Asthma Immunol. 2013;111:20–4.
There are 29 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Original Article
Authors

Nazlı Ercan 0000-0003-3216-8775

Project Number Project/Decision no: 19/412; Meeting no: 2019/18
Publication Date August 31, 2021
Submission Date August 25, 2020
Published in Issue Year 2021 Volume: 8 Issue: 2

Cite

APA Ercan, N. (2021). Point Prevalence, Risk Factors and Useful Parameters for Food Allergy in Children with Atopic Dermatitis. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 8(2), 84-90.
AMA Ercan N. Point Prevalence, Risk Factors and Useful Parameters for Food Allergy in Children with Atopic Dermatitis. MMJ. August 2021;8(2):84-90.
Chicago Ercan, Nazlı. “Point Prevalence, Risk Factors and Useful Parameters for Food Allergy in Children With Atopic Dermatitis”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 8, no. 2 (August 2021): 84-90.
EndNote Ercan N (August 1, 2021) Point Prevalence, Risk Factors and Useful Parameters for Food Allergy in Children with Atopic Dermatitis. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 8 2 84–90.
IEEE N. Ercan, “Point Prevalence, Risk Factors and Useful Parameters for Food Allergy in Children with Atopic Dermatitis”, MMJ, vol. 8, no. 2, pp. 84–90, 2021.
ISNAD Ercan, Nazlı. “Point Prevalence, Risk Factors and Useful Parameters for Food Allergy in Children With Atopic Dermatitis”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 8/2 (August 2021), 84-90.
JAMA Ercan N. Point Prevalence, Risk Factors and Useful Parameters for Food Allergy in Children with Atopic Dermatitis. MMJ. 2021;8:84–90.
MLA Ercan, Nazlı. “Point Prevalence, Risk Factors and Useful Parameters for Food Allergy in Children With Atopic Dermatitis”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, vol. 8, no. 2, 2021, pp. 84-90.
Vancouver Ercan N. Point Prevalence, Risk Factors and Useful Parameters for Food Allergy in Children with Atopic Dermatitis. MMJ. 2021;8(2):84-90.