Factors Affecting Tolerance Development in Children With Food Allergies

Öz

Although the prevalence of food allergy (FA) is unknown, it is estimated to have increased in recent years. In general, food allergies are more common in the pediatric age group than in adults. In our study, we aimed to determine the development of tolerance and the factors affecting it in children with food allergies. Medical records of cases followed up for FA were retrospectively reviewed between 2013 and 2016. Gender, age of first symptom, duration of breastfeeding, family history of atopy, multiple food allergies, concomitant allergic diseases and clinical evidence of the cases were evaluated. In addition, prick test results, total IgE and specific IgE levels, food challenge test results and tolerance development were evaluated. Of 319 patients 57.7% (184) were male. The average age of onset of symptoms was 3 months. The most common symptoms were related to the gastrointestinal system (69.9%), the skin (22.3%) and the respiratory system (6.3%). When the tolerance development rates were investigated by years, it was found that the tolerance developed 87.1% in the first year, 5.9 % in the second and 2.8% in the third year. The most common allergens are cow's milk (71.3%), eggs (17.6%), peanuts (2.8%), nuts (2.04%) and other foods such as strawberries, cocoa, peaches. The mother's smoking status was significantly associated with the development of tolerance. The rate of development of tolerance in the first year was significantly higher in non-Ig E-mediated allergies and single food allergies.

Anahtar Kelimeler

• children
• food allergy
• tolerance
• factors

Besin Alerjisi Tanılı Hastalarda Tolerans Gelişimi ve Toleransa Etki Eden Faktörler

Öz

Besin alerjisinin prevelansı bilinmemekle birlikte son yıllarda giderek arttığı tahmin edilmektedir. Genel olarak besin alerjileri pediatrik yaş grubunda erişkine oranla daha sık görülür. Çalışmamızda; polikliniğimizde gıda alerjisi tanısı olan hastalarımızın, doğal seyri, tolerans gelişimi ve toleransa etki eden faktörleri belirlemeyi hedefledik. Ocak 2013-Ocak 2016 yılı arasında polikliniğimizde Besin Alerjisi tanısı alan hastaların dosyaları retrospektif olarak incelendi. Hastaların cinsiyetleri, ilk semptom yaşı, anne sütü alma süresi, ailede atopi öyküsü, çoklu besin alerjisi, ek alerjik hastalık varlığı ve klinik bulguları değerlendirildi. Hastaların prik test sonuçları, total IgE, spesifik IgE, düzeyleri ve tolerans geliştirme durumları değerlendirildi. 319 hastanın 184’ü erkek (%57.7) idi. Hastaların 127’sinde (%39.8) ailede atopi öyküsü ve 71’inde (%22.3) çoklu besin alerjisi mevcuttu. Hastalarda görülen en sık semptom, %65.8 gastrointestinal sistem, %21 cilt bulguları, %6.3 solunum bulgularıydı. Hastaların semptom yaşı 5.8 ± 9,7 ay; tanı yaşı 6.6 ± 9.08 aydı. Hastaların yıllara göre tolerans geliştirme oranları; Birinci yıl 287 (%87,1) ikinci yıl 19’unda (%5,9) üçüncü yıl 9’unda (% 2,8) olarak saptandı. En sık alerjen gıda inek sütü (%71,3), yumurta (%17,6), fıstık (2,8), fındık (%2,04) olmakla beraber diğer gıdalar çilek, kakao, şeftali, buğday, soya, balık olarak saptandı. Çalışmamızda ilk yılda annenin sigara kullanımı ile besin alerjilerinde tolerans gelişimi arasında anlamlı fark saptanmıştır. Non Ig E aracılı besin alerjisi olanlar ve tek besine karşı alerjen olan hastalarda ilk yılda tolerans gelişimi anlamlı oranda faza saptanmıştır.

Anahtar Kelimeler

• children
• food allergies
• tolerance

Kaynakça

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