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Factors Affecting Tolerance Development in Children With Food Allergies

Yıl 2023, Cilt: 45 Sayı: 1, 79 - 87, 23.01.2023
https://doi.org/10.20515/otd.1138002

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.

Kaynakça

  • 1. Woods RK, Abramson M, Bailey M, Walters EH. International prevalences of reported food allergies and intolerances. Comparisons arising from the European Community Respiratory Health Survey (ECRHS) 1991-1994. Eur J Clin Nutr. 2001;55:298-304.
  • 2. Bischoff S, Crowe SE. Food allergy and the gastrointestinal tract. Curr Opin Gastroenterol. 2004 Mar;20:156-61.
  • 3. Ko J, Mayer L. Oral tolerance: lessons on treatment of food allergy. Eur J Gastroenterol 21Hepatol. 2005;17:1299-303.
  • 4. Brandtzaeg PE. Current understanding of gastrointestinal immunoregulation and its relation to food allergy. Ann N Y Acad Sci. 2002;964: 13-45.
  • 5. Chin JJ. Revisiting the "hygiene hypothesis" in gastrointestinal allergy. Curr Opin Gastroenterol. 2002;18:705-10.
  • 6. Crespo JF, Rodriguez J. Food allergy in adulthood. Allergy. 2003;58:98-113.
  • 7. van Ree R. Clinical importance of cross-reactivity in food allergy. Curr Opin Allergy Clin Immunol. 2004;4:235-40.
  • 8. Bock SA, Sampson HA, Atkins FM, Zeiger RS, Lehrer S, Sachs M, Bush RK, Metcalfe DD. Double-blind, placebo-controlled food challenge (DBPCFC) as an office procedure: a manual. J Allergy Clin Immunol. 1988 ;82:986-97.
  • 9. Deckers IA. McLean S. Linssen S. Mommers M. van Schayck CP. Sheikh A. Investigating international time trends in the incidence and prevalence of atopic eczema 1990-2010: a systematic review of epidemiological studies. PLoS One 2012;7:e39803.
  • 10. Anandan C, Gupta R, Simpson CR, Fischbacher C, Sheikh A. Epidemiology and disease burden from allergic disease in Scotland: analyses of national databases. J R Soc Med. 2009;102:431-42.
  • 11. Anandan C, Nurmatov U, van Schayck OC, Sheikh A. Is the prevalence of asthma declining? Systematic review of epidemiological studies. Allergy. 2010 ;65:152-67.
  • 12. Gupta R, Sheikh A, Strachan DP, Anderson HR. Burden of allergic disease in the UK: secondary analyses of national databases. Clin Exp Allergy. 2004;34:520-6.
  • 13. Schoenwetter WF, Dupclay L Jr, Appajosyula S, Botteman MF, Pashos CL. Economic impact and quality-of-life burden of allergic rhinitis. Curr Med Res Opin. 2004;20:305-17.
  • 14. Allen KJ, Koplin JJ. The epidemiology of IgE-mediated food allergy and anaphylaxis. Immunol Allergy Clin North Am. 2012 ;32:35-50.
  • 15. Sampson HA. Food allergy--accurately identifying clinical reactivity. Allergy. 2005;60 Suppl 79:19-24.
  • 16. Prescott S, Allen KJ. Food allergy: riding the second wave of the allergy epidemic. Pediatr Allergy Immunol. 2011;22:155-60.
  • 17. Lack G. Update on risk factors for food allergy. J Allergy Clin Immunol. 2012 ;129:1187-97.
  • 18. Sicherer SH. Epidemiology of food allergy. J Allergy Clin Immunol. 2011;127:594-602.
  • 19. Dias A, Santos A, Pinheiro JA. Persistence of cow's milk allergy beyond two years of age. Allergol Immunopathol (Madr). 2010;38:8-12.
  • 20. Orhan F, Karakas T, Cakir M, Aksoy A, Baki A, Gedik Y. Prevalence of immunoglobulin E-mediated food allergy in 6-9-year-old urban schoolchildren in the eastern Black Sea region of Turkey. Clin Exp Allergy. 2009;39:1027-35.
  • 21. Steinke M, Fiocchi A, Kirchlechner V, Ballmer-Weber B, Brockow K, Hischenhuber C, Dutta M, Ring J, Urbanek R, Terracciano L, Wezel R; REDALL study consortium. Perceived food allergy in children in 10 European nations. A randomised telephone survey. Int Arch Allergy Immunol. 2007;143:290-5.
  • 22. Rancé F, Grandmottet X, Grandjean H. Prevalence and main characteristics of schoolchildren diagnosed with food allergies in France. Clin Exp Allergy. 2005;35:167-72.
  • 23. Rona RJ, Chinn S. Parents' perceptions of food intolerance in primary school children. Br Med J (Clin Res Ed). 1987 ;294:863-6.
  • 24. Dubakiene R. Kavaliünas A. Surkiene G. Zagminas K. StukasR. Food allergies amongVilnius city primary school children. Biologija 2011;57:103–9.
  • 25. Kristjansson I, Ardal B, Jonsson JS, Sigurdsson JA, Foldevi M, Björkstén B. Adverse reactions to food and food allergy in young children in Iceland and Sweden. Scand J Prim Health Care. 1999;17:30-4. 26. Fiocchi A, Assa'ad A, Bahna S; Adverse Reactions to Foods Committee; American College of Allergy, Asthma and Immunology. Food allergy and the introduction of solid foods to infants: a consensus document. Adverse Reactions to Foods Committee, American College of Allergy, Asthma and Immunology. Ann Allergy Asthma Immunol. 2006;97:10-20; quiz 21, 77.
  • 27. Liu AH, Jaramillo R, Sicherer SH, Wood RA, Bock SA, Burks AW, Massing M, Cohn RD, Zeldin DC. National prevalence and risk factors for food allergy and relationship to asthma: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol. 2010;126:798-806.e13.
  • 28. Shek LP, Soderstrom L, Ahlstedt S, Beyer K, Sampson HA. Determination of food specific IgE levels over time can predict the development of tolerance in cow's milk and hen's egg allergy. J Allergy Clin Immunol. 2004;114:387-91.
  • 29. Sicherer SH. Epidemiology of food allergy. J Allergy Clin Immunol. 2011;127:594-602.
  • 30. Dannaeus A, Inganäs M. A follow-up study of children with food allergy. Clinical course in relation to serum IgE- and IgG-antibody levels to milk, egg and fish. Clin Allergy. 1981;11:533-9.
  • 31. Agostoni C, Decsi T, Fewtrell M, Goulet O, Kolacek S, Koletzko B, Michaelsen KF, Moreno L, Puntis J, Rigo J, Shamir R, Szajewska H, Turck D, van Goudoever J; ESPGHAN Committee on Nutrition:. Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2008;46:99-110.
  • 32. Hattevig G, Kjellman B, Björkstén B. Clinical symptoms and IgE responses to common food proteins and inhalants in the first 7 years of life. Clin Allergy. 1987;17:571-8.
  • 33. Boyano-Martínez T, García-Ara C, Díaz-Pena JM, Martín-Esteban M. Prediction of tolerance on the basis of quantification of egg white-specific IgE antibodies in children with egg allergy. J Allergy Clin Immunol. 2002;110:304-9.
  • 34. Savage JH, Matsui EC, Skripak JM, Wood RA. The natural history of egg allergy. J Allergy Clin Immunol. 2007;120:1413-7.
  • 35. Sicherer SH, Wood RA, Vickery BP, Jones SM, Liu AH, Fleischer DM, Dawson P, Mayer L, Burks AW, Grishin A, Stablein D, Sampson HA. The natural history of egg allergy in an observational cohort. J Allergy Clin Immunol. 2014 ;133:492-9.
  • 36. Cook DG, Strachan DP. Health effects of passive smoking-10: Summary of effects of parental smoking on the respiratory health of children and implications for research. Thorax. 1999;54:357-66.
  • 37. Strachan DP, Cook DG. Health effects of passive smoking. 6. Parental smoking and childhood asthma: longitudinal and case-control studies. Thorax. 1998;53:204-12.
  • 38. Tariq SM, Matthews SM, Hakim EA, Stevens M, Arshad SH, Hide DW. The prevalence of and risk factors for atopy in early childhood: a whole population birth cohort study. J Allergy Clin Immunol. 1998;101:587-93.
  • 39. Ponsonby AL, Couper D, Dwyer T, Carmichael A. Cross sectional study of the relation between sibling number and asthma, hay fever, and eczema. Arch Dis Child. 1998;79:328-33.
  • 40. Arshad SH. Primary prevention of asthma and allergy. J Allergy Clin Immunol. 2005;116:3-14; quiz 15.
  • 41. Skripak JM, Matsui EC, Mudd K, Wood RA. The natural history of IgE-mediated cow's milk allergy. J Allergy Clin Immunol. 2007;120:1172-7.
  • 42. Santos A, Dias A, Pinheiro JA. Predictive factors for the persistence of cow's milk allergy. Pediatr Allergy Immunol. 2010;21:1127-34.
  • 43. Meyer R, Chebar Lozinsky A, Fleischer DM, Vieira MC, Du Toit G, Vandenplas Y, Dupont C, Knibb R, Uysal P, Cavkaytar O, Nowak-Wegrzyn A, Shah N, Venter C. Diagnosis and management of Non-IgE gastrointestinal allergies in breastfed infants-An EAACI Position Paper. Allergy. 2020;75:14-32.
  • 44. Koksal BT, Barıs Z, Ozcay F, Yilmaz Ozbek O. Single and multiple food allergies in infants with proctocolitis. Allergol Immunopathol (Madr). 2018;46:3-8.
  • 45. Buyuktiryaki B, Kulhas Celik I, Erdem SB, Capanoglu M, Civelek E, Guc BU, Guvenir H, Cakir M, Dibek Misirlioglu E, Akcal O, Volkan B, Toyran M, Sag E, Kertel AC, Ginis T, Kocabas CN, Orhan F, Can D. Risk Factors Influencing Tolerance and Clinical Features of Food Protein-induced Allergic Proctocolitis. J Pediatr Gastroenterol Nutr. 2020;70:574-79.
  • 46. Du Toit G, Sampson HA, Plaut M, Burks AW, Akdis CA, Lack G. Food allergy: Update on prevention and tolerance. J Allergy Clin Immunol. 2018;141:30-40.
  • 47. Perkin MR, Logan K, Marrs T, Radulovic S, Craven J, Flohr C, Lack G; EAT Study Team. Enquiring About Tolerance (EAT) study: Feasibility of an early allergenic food introduction regimen. J Allergy Clin Immunol. 2016;137:1477-1486.e8.
  • 48. Fernández-Rivas M, Barreales L, Mackie AR, Fritsche P, Vázquez-Cortés S, Jedrzejczak-Czechowicz M, Kowalski ML, Clausen M, Gislason D, Sinaniotis A, Kompoti E, Le TM, Knulst AC, Purohit A, de Blay F, Kralimarkova T, Popov T, Asero R, Belohlavkova S, Seneviratne SL, Dubakiene R, Lidholm J, Hoffmann-Sommergruber K, Burney P, Crevel R, Brill M, Fernández-Pérez C, Vieths S, Clare Mills EN, van Ree R, Ballmer-Weber BK. The EuroPrevall outpatient clinic study on food allergy: background and methodology. Allergy. 2015;70:576-84.
  • 49. Longo G, Berti I, Burks AW, Krauss B, Barbi E. IgE-mediated food allergy in children. The Lancet. 2013;382:1656-64.

Besin Alerjisi Tanılı Hastalarda Tolerans Gelişimi ve Toleransa Etki Eden Faktörler

Yıl 2023, Cilt: 45 Sayı: 1, 79 - 87, 23.01.2023
https://doi.org/10.20515/otd.1138002

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.

Kaynakça

  • 1. Woods RK, Abramson M, Bailey M, Walters EH. International prevalences of reported food allergies and intolerances. Comparisons arising from the European Community Respiratory Health Survey (ECRHS) 1991-1994. Eur J Clin Nutr. 2001;55:298-304.
  • 2. Bischoff S, Crowe SE. Food allergy and the gastrointestinal tract. Curr Opin Gastroenterol. 2004 Mar;20:156-61.
  • 3. Ko J, Mayer L. Oral tolerance: lessons on treatment of food allergy. Eur J Gastroenterol 21Hepatol. 2005;17:1299-303.
  • 4. Brandtzaeg PE. Current understanding of gastrointestinal immunoregulation and its relation to food allergy. Ann N Y Acad Sci. 2002;964: 13-45.
  • 5. Chin JJ. Revisiting the "hygiene hypothesis" in gastrointestinal allergy. Curr Opin Gastroenterol. 2002;18:705-10.
  • 6. Crespo JF, Rodriguez J. Food allergy in adulthood. Allergy. 2003;58:98-113.
  • 7. van Ree R. Clinical importance of cross-reactivity in food allergy. Curr Opin Allergy Clin Immunol. 2004;4:235-40.
  • 8. Bock SA, Sampson HA, Atkins FM, Zeiger RS, Lehrer S, Sachs M, Bush RK, Metcalfe DD. Double-blind, placebo-controlled food challenge (DBPCFC) as an office procedure: a manual. J Allergy Clin Immunol. 1988 ;82:986-97.
  • 9. Deckers IA. McLean S. Linssen S. Mommers M. van Schayck CP. Sheikh A. Investigating international time trends in the incidence and prevalence of atopic eczema 1990-2010: a systematic review of epidemiological studies. PLoS One 2012;7:e39803.
  • 10. Anandan C, Gupta R, Simpson CR, Fischbacher C, Sheikh A. Epidemiology and disease burden from allergic disease in Scotland: analyses of national databases. J R Soc Med. 2009;102:431-42.
  • 11. Anandan C, Nurmatov U, van Schayck OC, Sheikh A. Is the prevalence of asthma declining? Systematic review of epidemiological studies. Allergy. 2010 ;65:152-67.
  • 12. Gupta R, Sheikh A, Strachan DP, Anderson HR. Burden of allergic disease in the UK: secondary analyses of national databases. Clin Exp Allergy. 2004;34:520-6.
  • 13. Schoenwetter WF, Dupclay L Jr, Appajosyula S, Botteman MF, Pashos CL. Economic impact and quality-of-life burden of allergic rhinitis. Curr Med Res Opin. 2004;20:305-17.
  • 14. Allen KJ, Koplin JJ. The epidemiology of IgE-mediated food allergy and anaphylaxis. Immunol Allergy Clin North Am. 2012 ;32:35-50.
  • 15. Sampson HA. Food allergy--accurately identifying clinical reactivity. Allergy. 2005;60 Suppl 79:19-24.
  • 16. Prescott S, Allen KJ. Food allergy: riding the second wave of the allergy epidemic. Pediatr Allergy Immunol. 2011;22:155-60.
  • 17. Lack G. Update on risk factors for food allergy. J Allergy Clin Immunol. 2012 ;129:1187-97.
  • 18. Sicherer SH. Epidemiology of food allergy. J Allergy Clin Immunol. 2011;127:594-602.
  • 19. Dias A, Santos A, Pinheiro JA. Persistence of cow's milk allergy beyond two years of age. Allergol Immunopathol (Madr). 2010;38:8-12.
  • 20. Orhan F, Karakas T, Cakir M, Aksoy A, Baki A, Gedik Y. Prevalence of immunoglobulin E-mediated food allergy in 6-9-year-old urban schoolchildren in the eastern Black Sea region of Turkey. Clin Exp Allergy. 2009;39:1027-35.
  • 21. Steinke M, Fiocchi A, Kirchlechner V, Ballmer-Weber B, Brockow K, Hischenhuber C, Dutta M, Ring J, Urbanek R, Terracciano L, Wezel R; REDALL study consortium. Perceived food allergy in children in 10 European nations. A randomised telephone survey. Int Arch Allergy Immunol. 2007;143:290-5.
  • 22. Rancé F, Grandmottet X, Grandjean H. Prevalence and main characteristics of schoolchildren diagnosed with food allergies in France. Clin Exp Allergy. 2005;35:167-72.
  • 23. Rona RJ, Chinn S. Parents' perceptions of food intolerance in primary school children. Br Med J (Clin Res Ed). 1987 ;294:863-6.
  • 24. Dubakiene R. Kavaliünas A. Surkiene G. Zagminas K. StukasR. Food allergies amongVilnius city primary school children. Biologija 2011;57:103–9.
  • 25. Kristjansson I, Ardal B, Jonsson JS, Sigurdsson JA, Foldevi M, Björkstén B. Adverse reactions to food and food allergy in young children in Iceland and Sweden. Scand J Prim Health Care. 1999;17:30-4. 26. Fiocchi A, Assa'ad A, Bahna S; Adverse Reactions to Foods Committee; American College of Allergy, Asthma and Immunology. Food allergy and the introduction of solid foods to infants: a consensus document. Adverse Reactions to Foods Committee, American College of Allergy, Asthma and Immunology. Ann Allergy Asthma Immunol. 2006;97:10-20; quiz 21, 77.
  • 27. Liu AH, Jaramillo R, Sicherer SH, Wood RA, Bock SA, Burks AW, Massing M, Cohn RD, Zeldin DC. National prevalence and risk factors for food allergy and relationship to asthma: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol. 2010;126:798-806.e13.
  • 28. Shek LP, Soderstrom L, Ahlstedt S, Beyer K, Sampson HA. Determination of food specific IgE levels over time can predict the development of tolerance in cow's milk and hen's egg allergy. J Allergy Clin Immunol. 2004;114:387-91.
  • 29. Sicherer SH. Epidemiology of food allergy. J Allergy Clin Immunol. 2011;127:594-602.
  • 30. Dannaeus A, Inganäs M. A follow-up study of children with food allergy. Clinical course in relation to serum IgE- and IgG-antibody levels to milk, egg and fish. Clin Allergy. 1981;11:533-9.
  • 31. Agostoni C, Decsi T, Fewtrell M, Goulet O, Kolacek S, Koletzko B, Michaelsen KF, Moreno L, Puntis J, Rigo J, Shamir R, Szajewska H, Turck D, van Goudoever J; ESPGHAN Committee on Nutrition:. Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2008;46:99-110.
  • 32. Hattevig G, Kjellman B, Björkstén B. Clinical symptoms and IgE responses to common food proteins and inhalants in the first 7 years of life. Clin Allergy. 1987;17:571-8.
  • 33. Boyano-Martínez T, García-Ara C, Díaz-Pena JM, Martín-Esteban M. Prediction of tolerance on the basis of quantification of egg white-specific IgE antibodies in children with egg allergy. J Allergy Clin Immunol. 2002;110:304-9.
  • 34. Savage JH, Matsui EC, Skripak JM, Wood RA. The natural history of egg allergy. J Allergy Clin Immunol. 2007;120:1413-7.
  • 35. Sicherer SH, Wood RA, Vickery BP, Jones SM, Liu AH, Fleischer DM, Dawson P, Mayer L, Burks AW, Grishin A, Stablein D, Sampson HA. The natural history of egg allergy in an observational cohort. J Allergy Clin Immunol. 2014 ;133:492-9.
  • 36. Cook DG, Strachan DP. Health effects of passive smoking-10: Summary of effects of parental smoking on the respiratory health of children and implications for research. Thorax. 1999;54:357-66.
  • 37. Strachan DP, Cook DG. Health effects of passive smoking. 6. Parental smoking and childhood asthma: longitudinal and case-control studies. Thorax. 1998;53:204-12.
  • 38. Tariq SM, Matthews SM, Hakim EA, Stevens M, Arshad SH, Hide DW. The prevalence of and risk factors for atopy in early childhood: a whole population birth cohort study. J Allergy Clin Immunol. 1998;101:587-93.
  • 39. Ponsonby AL, Couper D, Dwyer T, Carmichael A. Cross sectional study of the relation between sibling number and asthma, hay fever, and eczema. Arch Dis Child. 1998;79:328-33.
  • 40. Arshad SH. Primary prevention of asthma and allergy. J Allergy Clin Immunol. 2005;116:3-14; quiz 15.
  • 41. Skripak JM, Matsui EC, Mudd K, Wood RA. The natural history of IgE-mediated cow's milk allergy. J Allergy Clin Immunol. 2007;120:1172-7.
  • 42. Santos A, Dias A, Pinheiro JA. Predictive factors for the persistence of cow's milk allergy. Pediatr Allergy Immunol. 2010;21:1127-34.
  • 43. Meyer R, Chebar Lozinsky A, Fleischer DM, Vieira MC, Du Toit G, Vandenplas Y, Dupont C, Knibb R, Uysal P, Cavkaytar O, Nowak-Wegrzyn A, Shah N, Venter C. Diagnosis and management of Non-IgE gastrointestinal allergies in breastfed infants-An EAACI Position Paper. Allergy. 2020;75:14-32.
  • 44. Koksal BT, Barıs Z, Ozcay F, Yilmaz Ozbek O. Single and multiple food allergies in infants with proctocolitis. Allergol Immunopathol (Madr). 2018;46:3-8.
  • 45. Buyuktiryaki B, Kulhas Celik I, Erdem SB, Capanoglu M, Civelek E, Guc BU, Guvenir H, Cakir M, Dibek Misirlioglu E, Akcal O, Volkan B, Toyran M, Sag E, Kertel AC, Ginis T, Kocabas CN, Orhan F, Can D. Risk Factors Influencing Tolerance and Clinical Features of Food Protein-induced Allergic Proctocolitis. J Pediatr Gastroenterol Nutr. 2020;70:574-79.
  • 46. Du Toit G, Sampson HA, Plaut M, Burks AW, Akdis CA, Lack G. Food allergy: Update on prevention and tolerance. J Allergy Clin Immunol. 2018;141:30-40.
  • 47. Perkin MR, Logan K, Marrs T, Radulovic S, Craven J, Flohr C, Lack G; EAT Study Team. Enquiring About Tolerance (EAT) study: Feasibility of an early allergenic food introduction regimen. J Allergy Clin Immunol. 2016;137:1477-1486.e8.
  • 48. Fernández-Rivas M, Barreales L, Mackie AR, Fritsche P, Vázquez-Cortés S, Jedrzejczak-Czechowicz M, Kowalski ML, Clausen M, Gislason D, Sinaniotis A, Kompoti E, Le TM, Knulst AC, Purohit A, de Blay F, Kralimarkova T, Popov T, Asero R, Belohlavkova S, Seneviratne SL, Dubakiene R, Lidholm J, Hoffmann-Sommergruber K, Burney P, Crevel R, Brill M, Fernández-Pérez C, Vieths S, Clare Mills EN, van Ree R, Ballmer-Weber BK. The EuroPrevall outpatient clinic study on food allergy: background and methodology. Allergy. 2015;70:576-84.
  • 49. Longo G, Berti I, Burks AW, Krauss B, Barbi E. IgE-mediated food allergy in children. The Lancet. 2013;382:1656-64.
Toplam 48 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Yasemin Ersözlü 0000-0003-2968-025X

Hulya Anıl 0000-0002-0889-2491

Koray Harmanci 0000-0002-8494-648X

Yayımlanma Tarihi 23 Ocak 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 45 Sayı: 1

Kaynak Göster

Vancouver Ersözlü Y, Anıl H, Harmanci K. Factors Affecting Tolerance Development in Children With Food Allergies. Osmangazi Tıp Dergisi. 2023;45(1):79-87.


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