IgE Aracılı Besin Alerjili Çocuklarda Alerjen Profilinin Retrospektif Değerlendirilmesi

Abstract

Besin alerjileri, genellikle çocukluk çağında daha sık görülür ve hayatı tehdit eden reaksiyonlara yol açabilir. Besin alerjisinin yaygınlığı toplumlar arasında farklılık göstermekle birlikte, yapılan çalışmalarda bu alerjilerin sıklığı %1 ile %10 arasında değişmektedir. Alerjik reaksiyonlara en sık neden olan besinler arasında süt, yumurta, buğday, yer fıstığı, kuruyemişler, balık ve deniz ürünleri bulunmaktadır. Bu çalışmada Bursa Uludağ Üniversitesi Tıp Fakültesi Hastanesi Çocuk Alerji Polikliniği’ne Haziran 2015-Haziran 2020 tarihleri arasında başvuran IgE aracılı besin alerjili çocuklarda alerjen profilinin değerlendirilmesi amaçlanmıştır. Hastaların %63,6’sı erkek, ortalama başvuru yaşı ise 3,06 yıl olarak bulunmuştur. Hastaların çoğu (%80,4) deri şikayetleri ile başvurmuştur. %10,2’sinde besinlere karşı anafilaksi gelişmiştir. Hastaların %39,8’inde atopi ile ilişkili hastalıklar mevcuttur. Atopik dermatit, en sık görülen eşlik eden alerjik hastalıktır ve IgE aracılı besin alerjileri ile sıklıkla ilişkilidir. Deri prik testi ve serum spesifik IgE test sonuçları, en sık alerjiye neden olan besinlerin sırasıyla yumurta ve süt olduğunu göstermektedir. Bunun dışında fındık, yer fıstığı, ceviz gibi diğer besin alerjenleri de sıklıkla tespit edilmiştir. Tedavi sürecinde, hastaların durumuna göre diyet ve ilaç tedavisi kombinasyonu kullanılarak alerjik reaksiyonların kontrol altına alınması hedeflenmiştir. Sonuç olarak, bu çalışma, besin alerjilerinin erken dönemde tanınmasının ve doğru tedavi yöntemlerinin uygulanmasının önemini vurgulamaktadır. Besin alerjilerinin doğru şekilde tanınması, alerjenlerin diyetten çıkarılması ve gerekli tedavi yöntemlerinin uygulanması, hem hastaların sağlığını korumak hem de alerjik reaksiyonların önüne geçmek için kritik rol oynamaktadır.

Keywords

• Besin Alerjisi
• Cilt Döküntüsü
• Anafilaksi

A Clinical Profile of Ige-Mediated Food Allergies in Children: Experience from Bursa Uludag University

Abstract

Food allergies are more prevalent in childhood and can result in life-threatening reactions. Although prevalence rates vary among populations, studies have shown that the global prevalence of food allergies ranges from 1% to 10%. The most common food allergens include milk, eggs, wheat, peanuts, tree nuts, fish, and shellfish. This study aimed to evaluate the allergen profile of children diagnosed with IgE-mediated food allergies who were admitted to the Pediatric Allergy Outpatient Clinic at Bursa Uludağ University Faculty of Medicine Hospital between June 2015 and June 2020. Among the patients, 63.6% were male, and the mean age at the time of presentation was 3.06 years. The majority (80.4%) presented with dermatological symptoms, and 10.2% experienced food-induced anaphylaxis. Atopy-related conditions were observed in 39.8% of the patients, with atopic dermatitis being the most common coexisting allergic disease frequently associated with IgE-mediated food allergies. Skin prick tests and serum-specific IgE analyses revealed that eggs and milk were the most prevalent allergens, respectively. Other commonly identified allergens included hazelnuts, peanuts, and walnuts. Management strategies involved a combination of dietary elimination and pharmacological treatment tailored to the individual patient's condition. This study underscores the importance of early identification of food allergies and the implementation of appropriate treatment strategies. Accurate diagnosis, avoidance of allergenic foods, and timely therapeutic interventions are essential for safeguarding patient health and preventing adverse allergic reactions.

Keywords

• Food Allergy
• Skin Eruptions
• Anaphylaxis

References

1. 1.Calvani M, Anania C, Caffarelli C, et al. Food allergy: anupdated review on pathogenesis, diagnosis, prevention andmanagement. Acta Biomed. 2020;91(11-S):e2020012. Published 2020 Sep 15. doi:10.23750/abm.v91i11-S.10316.
2. 2.Spolidoro GCI, Amera YT, Ali MM, et al. Frequency of foodallergy in Europe: An updated systematic review and meta-analysis. Allergy. 2023;78(2):351-368. doi:10.1111/all.15560.
3. 3.Yavuz ST, Sahiner UM, Buyuktiryaki B, et al. Phenotypes ofIgE-mediated food allergy in Turkish children. Allergy AsthmaProc. 2011;32(6):47-55. doi:10.2500/aap.2011.32.3481.
4. 4.Calvani M, Anania C, Caffarelli C, et al. Food allergy: anupdated review on pathogenesis, diagnosis, prevention andmanagement. Acta Biomed. 2020;91(11-S):e2020012. Published 2020 Sep 15. doi:10.23750/abm.v91i11-S.10316.
5. 5.Greiwe J. Using oral food challenges to provide clarity andconfidence when diagnosing food allergies. J Food Allergy. 2021;3(1):3-7. Published 2021 Apr 1.doi:10.2500/jfa.2021.3.210002.
6. 6.Santos AF, Riggioni C, Agache I, et al. EAACI guidelines onthe management of IgE-mediated food allergy. Allergy. 2025;80(1):14-36. doi:10.1111/all.16345.
7. 7.Liu J, Guo S, Wang Y, et al. A survey on prevalence andparents' perceptions of food allergy in 3- to 16-year-oldchildren in Wuhan, China. World Allergy Organ J. 2024;17(3):100883. Published 2024 Feb 22.doi:10.1016/j.waojou.2024.100883.
8. 8.Willits EK, Park MA, Hartz MF, et al. Food Allergy: AComprehensive Population-Based Cohort Study. Mayo ClinProc. 2018;93(10):1423-1430. doi:10.1016/j.mayocp.2018.05.031.

9. 9.R. Gupta, J. Marvel, P. Tassinari, et al. Annals of Allergy,Asthma & Immunology 2023 Vol. 131 Issue 5 Pages S7-S8DOI: 10.1016/j.anai.2023.08.039.
10. 10.Çelebioğlu E, Akarsu A, Şahiner ÜM. IgE-mediated food allergy throughout life. Turk J Med Sci. 2021;51(1):49-60. Published 2021 Feb 26. doi:10.3906/sag-2006-95.
11. 11.Orhan F, Karakas T, Cakir M, et al. Prevalence ofimmunoglobulin E-mediated food allergy in 6-9-year-old urban schoolchildren in the eastern Black Sea region of Turkey. Clin Exp Allergy. 2009;39(7):1027-1035. doi:10.1111/j.1365-2222.2009.03263.x.
12. 12.Sicherer SH, Sampson HA. Food allergy: Epidemiology,pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014;133(2):291-308. doi:10.1016/j.jaci.2013.11.020.
13. 13.Köken G. Çocukluk çağı besin alerjilerinin klinikfenotiplendirmesi. 2019.
14. 14.AbdulAal N, Alalwan TA. The reported prevalence of foodallergy among school-aged children in Bahrain. Allergol Immunopathol (Madr). 2023;51(2):90-98. Published 2023 Mar1. doi:10.15586/aei.v51i2.785.
15. 15.Ho MH, Lee SL, Wong WH, Ip P, Lau YL. Prevalence of self-reported food allergy in Hong Kong children and teens--a population survey. Asian Pac J Allergy Immunol. 2012;30(4):275-284.
16. 16.Jimenez-Garcia R, Lopez-de-Andres A, Hernandez-Barrera V,et al. Hospitalizations for Food-Induced Anaphylaxis Between2016 and 2021: Population-Based Epidemiologic Study. JMIR Public Health Surveill. 2024;10:e57340. Published 2024 Aug27. doi:10.2196/57340.
17. 17.Nantanee R, Suratannon N, Chatchatee P. Characteristics andLaboratory Findings of Food-Induced Anaphylaxis in Children:Study in an Asian Developing Country. Int Arch AllergyImmunol. 2022;183(1):59-67. doi:10.1159/000518319.
18. 18.Pouessel G, Jean-Bart C, Deschildre A, et al. Food-induced anaphylaxis in infancy compared to preschool age: Aretrospective analysis. Clin Exp Allergy. 2020;50(1):74-81. doi:10.1111/cea.13519.
19. 19.Christensen MO, Barakji YA, Loft N, et al. Prevalence of andassociation between atopic dermatitis and food sensitivity, foodallergy and challenge-proven food allergy: A systematic reviewand meta-analysis. J Eur Acad Dermatol Venereol. 2023;37(5):984-1003. doi:10.1111/jdv.18919.
20. 20.Ishak R, Todter E, Sitarik AR, et al. Early childhood atopicphenotypes and the development of allergic respiratorydisease. Pediatr Allergy Immunol. 2023;34(9):e14029.doi:10.1111/pai.14029.
21. 21.Batais W, Altirkistani BA, Alswat AM, et al. The Prevalence ofAtopic Diseases Among Pediatric Food AllergicPatients. Cureus. 2023;15(7):e42149. Published 2023 Jul 19.doi:10.7759/cureus.42149.
22. 22.Samady W, Warren C, Kohli S, et al. The prevalence of atopicdermatitis in children with food allergy. Ann Allergy AsthmaImmunol. 2019;122(6):656-657.e1. doi:10.1016/j.anai.2019.03.019.
23. 23.Venter C, Roth-Walter F, Vassilopoulos E, Hicks A. Dietarymanagement of IgE and non-IgE-mediated food allergies inpediatric patients. Pediatr Allergy Immunol. 2024;35(3):e14100. doi:10.1111/pai.14100.