ALERJİK CİLT SEMPTOMLARI OLAN ÇOCUKLARDA BESİN KATKI MADDELERİ İLE YAMA TESTİ

Öz

Amaç: Besin katkı maddeleri, çocuklarda çeşitli alerjik semptomlara neden olabilir, ancak besin katkı maddelerine duyarlılığı araştıran çalışmalar sınırlıdır. Bu çalışmanın amacı, besin katkı yama testi (BKYT) ile alerjen duyarlılığı tespit edilen ve diyet önerilen hastalarda BKYT’nin tanısal değerini değerlendirmektir. Gereç ve Yöntemler: Ocak 2017 ile Ocak 2023 tarihleri arasında başvuran, hazır ve paketlenmiş gıdaların tüketimi ile ilişkili alerjik semptomlar bildiren ve BKYT uygulanan 218 yaş arası hastaların verileri retrospektif olarak kaydedildi. Bulgular: Çalışmamızda BKYT uygulanan toplam 342 hasta değer lendirildi. Bu 342 hastanın %28,7′sinde en az bir alerjene pozitiflik tespit edildi. BKYT uygulanan 342 hastanın 48′inde (%14,0) amarant şüpheli alerjen olarak tespit edildi. BKYT’de pozitiflik saptanan 98 hastanın 56′sında (%57,1) akut/aralıklı ürtiker en sık klinik başvuru sebebiydi. Ayrıca, BKYT pozitif olan 98 hastanın 58′inde (%59,2) semptomlara neden olabilecek şüpheli besin olarak şekerlemeler ve çikolata olarak belirlendi. BKYT pozitif olan hastaların %56,1’inin diyet uyguladığı ve %46,9’unun diyetten fayda gördüğü belirlendi. Ayrıca, 4aylık takipte, diyete tam olarak bağlı kalmayan 45 hastada (%45,9) hassasiyet gösterdikleri allerjenin tüketiminde semptom ların tekrar ortaya çıktığı tespit edildi. Sonuç: İşlenmiş gıdaları tükettikten sonra semptom tarifleyen hastalarda BKYT uygulanmasının faydalı olabileceği düşünülmek tedir, ancak bu konuyu destekleyecek daha fazla çalışmaya ihtiyaç vardır.

Anahtar Kelimeler

• Alerji
• amarant
• çocuklar
• besin katkı maddeleri
• yama testi

FOOD ADDITIVE PATCH TESTING IN CHILDREN WITH ALLERGIC SKIN SYMPTOMS

Öz

Objective: Food additives may cause various allergic symptoms in children; however, there are limited studies investigating sensi tivity to food additives. The aim of this study was to evaluate the diagnostic value of food additive patch testing (FAPT) in patients who have detected allergen sensitivity with FAPT and have been recommended a diet. Material and Methods: Data of patients aged 218 years who presented between January 2017 and January 2023, reported allergic symptoms associated with the consumption of prepared and pack aged foods and underwent FAPT were retrospectively recorded. Results: A total of 342 patients who underwent FAPT in our study were evaluated. The positivity rate for at least one allergen among the 342 patients was 28.7%. Amaranth was detected as a suspected allergen in 48 (14.0%) out of 342 patients who underwent FAPT. Among the 98 patients who tested positive for the FAPT, acute/ intermittent urticaria was found in 56 (57.1%) of them. Additionally, confectionery and chocolates were identified as suspicious foods that could cause symptoms in 58 (59.2%) of the 98 patients who tested positive for the FAPT. It was observed that 56.1% of the patients followed a diet after detecting the food additive product, and 46.9% of 98 patients who tested positive for the FAPT benefited from the diet. During the 4month followup, 45 patients (45.9%) who did not fully adhere to their diet experienced a recurrence of symptoms upon consuming the allergen to which they were sensitive. Conclusion: Performing a FAPT in patients describing symptoms after consuming processed foods may be beneficial; however, further studies are needed to support this issue.

Anahtar Kelimeler

• Allergy
• amaranth
• children
• food additives
• patch test

Kaynakça

1. Rulis AM, Levitt JA. FDA'S food ingredient approval process: Safety assurance based on scientific assessment. Regul Toxicol Pharmacol 2009;53(1):20-31. google scholar
2. Valluzzi RL, Fierro V, Arasi S, Mennini M, Pecora V, Fiocchi A. Allergy to food additives Curr Opin Allergy Clin Immunol 2019;19(3):256-62. google scholar
3. Wilson BG, Bahna SL. Adverse reactions to food additives Ann Allergy Asthma Immunol 2005;95(6):499-570. google scholar
4. Fuglsang G, Madsen C, Saval P, Osterballe O. Prevalence of intolerance to food additives among Danish school children Pediatr Allergy Immunol 1993;4:123-9. google scholar
5. Young E, Patel S, Stoneham M, Rona R, Wilkinson JD. The prevalence of reaction to food additives in a survey population. J R Coll Physicians Lond 1987;21(4):241-7. google scholar
6. Jansen JJ, Kardinaal AF, Huijbers G, Vlieg-Boerstra BJ, Martens BP, Ockhuizen T. Prevalence of food allergy and intolerance in the adult Dutch population J Allergy Clin Immunol 1994;93(2):446-56. google scholar
7. Witkowski M, Grajeta H, Gomułka K. Hypersensitivity Reactions to Food Additives-Preservatives, Antioxidants, Flavor Enhancers. Int J Environ Res Public Health 2022;19(18):11493. google scholar
8. Cudowska B, Kaczmarski M. Atopy patch test in the diagnosis of food allergy in children with atopic eczema dermatitis syndrome Rocz Akad Med Bialymst 2005;50:261-7. google scholar

9. Jurakić Toncić R, Lipozencić J. Role and significance of atopy patch test. Acta Dermatovenerol Croat 2010;18:38-55. google scholar
10. Anıl H, Harmancı K. Evaluation of contact sensitivity to food additives in children with atopic dermatitis Postepy Dermatol Alergol 2020;37:390-95. google scholar
11. Feketea G, Tsabouri S. Common food colourants and allergic reactions in children: myth or reality? Food Chem 2017;230:578-88. google scholar
12. Bahna SL, Burkhardt JG. The dilemma of allergy to food additives Allergy Asthma Proc 2018;39:3-8. google scholar
13. James WD, Rosenthal LE, Brancaccio RR, Marks JG Jr. American Academy of Dermatology Patch Testing Survey: Use and effectiveness of this procedure J Am Acad Dermatol 1992;26(6):991-4. google scholar
14. Simon RA. Adverse reactions to food additives Curr Allergy Asthma Rep 2003;3(1):62-6. google scholar
15. Velázquez-Sámano G, Collado-Chagoya R, Cruz-Pantoja RA, Velasco-Medina AA, Rosales-Guevara J. Reacciones de hipersensibilidad a aditivos alimentarios [Hypersensitivity reactions to food additives]. Rev Alerg Mex 2019;66(3):329-39. google scholar
16. Park HW, Park CH, Park SH, Park JY, Park HS, Yang HJ et al. Dermatologic adverse reactions to 7 common food additives in patients with allergic diseases: a double-blind, placebo-controlled study J Allergy Clin Immunol 2008;121(4):1059-61. google scholar
17. Catli G, Bostanci I, Ozmen S, Dibek Misirlioglu E, Duman H, Ertan U. Is Patch Testing with Food Additives Useful in Children with Atopic Eczema? Pediatr Dermatol 2015;32:684-9. google scholar
18. Sadowska B, Sztormowska M, Gawinowska M, Chełmińska M. Carmine allergy in urticaria patients Postepy Dermatol Alergol 2022;39(1):94-100. google scholar
19. Lajoinie A, Henin E, Kassai B. Choisir la forme pharmaceutique orale la plus adaptée à l'enfant [Oral formulation of choice for children]. Arch Pediatr 2015;22:877-85. google scholar
20. Andreozzi L, Giannetti A, Cipriani F, Caffarelli C, Mastrorilli C, Ricci G. Hypersensitivity reactions to food and drug additives: problem or myth?Acta Biomed 2019;90(3-S):80-90. google scholar
21. Machler BC, Jacob SE. Carmine Red: A Potentially Overlooked Allergen in Children Dermatitis 2018;29(2):92-3. google scholar
22. Ramsey NB, Tuano KTS, Davis CM, Dillard K, Hanson C. Annatto seed hypersensitivity in a pediatric patient. Ann Allergy Asthma Immunol 2016;117:331-3. google scholar
23. Ozceker D, Dilek F, Yucel E, Tamay Z, Ozkaya E, Guler N. Can allergy patch tests with food additives help to diagnose the cause in childhood chronic spontaneous urticaria? Postepy Dermatol Alergol 2020;37:384-9. google scholar
24. Asero R. A strange case of “tuna allergy.” Allergy. 1998; 53: 816 817. Stevenson DD, Simon RA, Lumry WR, Mathison DA. Adverse reactions to tartrazine J Allergy Clin Immunol 1986;78(1 Pt 2):182-91 google scholar
25. Rajan JP, Simon RA, Bosso JV. Prevalence of sensitivity to food and drug additives in patients with chronic urticaria J Allergy Clin Immunol Pract 2014;2:168-71. google scholar