Atopik Dermatitli Çocuk Hastalarda Besin Duyarlılığının Değerlendirilmesi

Öz

Amaç: Atopik dermatit, gıda alerjilerinin gelişimi için önemli bir risk faktörü olarak kabul edilmektedir. Bu retrospektif çalışmada, atopik dermatitli pediatrik hastalardaki besin duyarlılığının deri prik testlerine göre değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya, hastanemiz Pediatrik Alerji Kliniğinde 1 Ocak 2023 ve 31 Ocak 2024 tarihleri arasında besin alerjenleriyle deri prik testleri uygulanan atopik dermatit tanılı çocuk hastalar dahil edilmiştir. Demografik veriler, atopik dermatit başlangıç yaşı, şiddeti, tedavileri ve eşlik eden atopik hastalıklar (astım, alerjik rinit) tıbbi kayıtlardan toplanmıştır. Deri prik testlerinin sonuçları retrospektif olarak değerlendirilmiştir. Bulgular: Çalışmaya %64,2'si erkek ve ortalama yaşları 7 ay (Çeyrekler arası aralık [ÇAA]: 5-14) olan 229 hasta katıldı. Atopik dermatit başlangıç yaş ortancası 3 (ÇAA:2-6) aydı. Hastaların 12'sinde (%5,2) eşlik eden diğer alerjik hastalıklar mevcuttu. SCORAD'a (Atopik dermatit ağırlık ölçeği) göre atopik dermatit şiddeti hastaların %61,1'inde hafif, %29,3'ünde orta ve %9,6'sında şiddetliydi. Hastaların 73'ünde (%31,9), en sık yumurta (%28,4) ile olmak üzere besin alerjen duyarlılığı saptandı. Hastaların %10'unda (n=23) çoklu besin duyarlılığı saptandı. Duyarlılık saptanan hastalarda atopik dermatitin daha erken başladığı, toplam IgE ve eozinofil sayılarının daha yüksek olduğu ve orta-şiddetli atopik dermatitin daha sık olduğu görüldü (p<0.05). Çok değişkenli analizde, atopik dermatitin 3 aydan önce başlaması, orta-şiddetli atopik dermatit ve eozinofil sayısının >500/mm3 olması duyarlılık için risk faktörleri olarak belirlendi. Sonuç: Pediatrik atopik dermatit hastalarının yaklaşık üçte birinde, en sık yumurta ile olmak üzere, en az bir gıda alerjenine karşı duyarlılık saptanmıştır. Atopik dermatit erken yaşlarda başlaması, yüksek eozinofil sayısı ve atopik dermatitin orta-şiddetli olması, besin alerjen duyarlılığı için daha yüksek risk oluşturur. Bu nedenle, gereksiz eliminasyon diyetlerinin önüne geçebilmek için bu grup hastaların özellikle çocuk alerji kliniklerine yönlendirilmesi çok önemlidir.

Anahtar Kelimeler

• Atopik dermatit
• deri prik testi
• besin alerjisi
• besin duyarlılığı
• yumurta alerjisi

EVALUATION OF FOOD SENSITIVITY IN CHILDREN WITH ATOPIC DERMATITIS

Öz

Objective: Atopic dermatitis is considered an important risk factor for the development of food allergies. This retrospective study aimed to evaluate food sensitivity in pediatric patients with atopic dermatitis based on skin prick tests. Material and Methods: The study included children diagnosed with atopic dermatitis who underwent skin prick tests with food allergens at our hospital’s Pediatric Allergy Clinic between January 1, 2023 and January 31, 2024. Demographic data, atopic dermatitis onset age, severity, treatments, and co-existing atopic diseases (asthma, allergic rhinitis) were collected from medical records. Skin prick test results were evaluated retrospectively. Results: The study comprised 229 patients, predominantly male (64.2%) with a median age of 7 months (IQR:5-14). The median age at atopic dermatitis onset was 3 (IQR:2-6) months. Co-existing allergic diseases were present in 12 (5.2%) patients. Based on SCORing Atopic Dermatitis (SCORAD), atopic dermatitis severity was mild in 61.1%, moderate in 29.3%, and severe in 9.6% of patients. Food allergen sensitization was observed in 73 (31.9%) patients, predominantly to hen's egg (28.4%). Multiple food sensitivities occurred in 10% of patients (n=23). Patients with food sensitivityshowed earlier atopic dermatitis onset, higher total IgE and eosinophil counts, and more frequent moderate-severe atopic dermatitis (p<0.05). Multivariate analysis identified atopic dermatitis onset before 3 months, moderate-severe atopic dermatitis, and eosinophils >500/ mm3 as risk factors for sensitization. Conclusion: Approximately one-third of pediatric atopic dermatitis patients exhibited sensitivity to at least one food allergen, most commonly hen’s egg. Early atopic dermatitis onset, elevated eosinophils, and moderate-severe atopic dermatitis pose a higher risk for sensitization. Hence, mitigating unnecessary elimination diets and prompt referral of these patients to pediatric allergy clinics is crucial.

Anahtar Kelimeler

• Atopic dermatitis
• skin prick test
• food allergy
• food sensitivity
• egg allergy

Kaynakça

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