Evaluation of the frequency of food allergy and disease severity in patients with atopic dermatitis

Öz

Purpose Atopic dermatitis is the most common chronic inflammatory skin disease in childhood. Aim of this study is to investigate the effects of food allergy and other factors on severity of atopic dermatitis. Materials and methods Clinical, demographic characteristics and laboratory values of 130 patients with atopic dermatitis (AD) were evaluated. The patients were grouped according to disease severity as “mild” and “moderate/severe”. Food sensitivity was evaluated with skin test and specific-IgE levels. Food allergy was diagnosed with oral food challenge. Results Mean age was 20.9±16.3(2-70) months, 54.6% were male. The onset age of complaints was 5.7±5(0.5-34) months. According to the severity of AD, 37% of patients were mild, 37% moderate, and 26% severe. While 65.4% of patients had food and 13.8% mite sensitivity, food allergy was detected in 38.5%. Responsible foods were eggs (62%), cow's milk-eggs (22%), cow's milk (12%) and hazelnut (4%). Patients with food allergy were younger (p<0.01), had a higher rate of onset before 6 months of age (p=0.03), higher total IgE (p=0.04) and lower vitamin D levels (p=0.03). In moderate/severe AD, rates of symptoms in first 6 months and during exclusive breastfeeding (p=0.021, p=0.01, respectively), rates of atopy and food allergy (p=0.048, p<0.001, respectively), and total IgE levels (p<0.01) were higher than mild patients. Conclusion It should be taken into account that symptoms in moderate/severe AD often develop in early infancy, food allergy accompanies more frequently and total IgE is higher, and unnecessary diets should be avoided in mild AD patients without food allergy.

Anahtar Kelimeler

• atopic dermatitis
• disease severity
• food allergy

Atopik dermatitli hastalarda besin alerjisi sıklığının ve hastalık şiddetinin değerlendirilmesi

Öz

Amaç: Atopik dermatit çocukluk çağının en sık görülen kronik enflamatuar deri hastalığıdır. Bu çalışmanın amacı atopik dermatitli çocuklarda besin alerjisi varlığının ve diğer faktörlerin atopik dermatit şiddeti üzerine etkisinin araştırılmasıdır.
Gereç ve yöntem: Çalışmada atopik dermatitli 130 hasta retrospektif olarak değerlendirildi; klinik, demografik özellikleri ve laboratuvar değerleri kaydedildi. Sonuçların karşılaştırılmasında hastalar, atopik dermatit şiddetine göre ‘hafif’ ve ‘orta veya ağır’ şiddette olmak üzere iki grupta değerlendirildi. Besin duyarlılığı varlığı deri prik testi ve besin spesifik IgE testi ile değerlendirildi. Besin alerjisi tanısı ise açık besin yükleme testi ile kondu.
Bulgular: Hastaların yaş ortalaması 20,9±16,3 (2-70) aydı, %54,6 (n=71)’si erkekti. Şikayet başlangıç zamanı 5,7±5 (0,5-34) aydı. Atopik dermatit şiddetine göre hastaların %37’si hafif, %37'si orta, %26'sı ağır idi. Hastaların %65,4’ünde besin, %13,8'inde akar duyarlılığı mevcuttu; %38,5 hastada besin alerjisi saptandı. Klinik ile ilişkili sorumlu besinler %62 yumurta, %22 inek sütü ve yumurta, %12 sadece inek sütü, %4 fındıktı. Besin alerjisi olan hastaların olmayanlara göre yaş ortalaması daha küçük (p<0,01), total IgE düzeyi daha yüksek (p=0,04), D vitamini düzeyleri daha düşük (p=0,03), şikayetlerin 6 aylıktan önce başlama oranı daha yüksekti (p=0,03). Orta/ağır atopik dermatitli hastalarda semptomların ilk 6 ayda ve sadece anne sütü ile beslenirken görülme oranları (sırasıyla, p=0,02 ve p=0,01), atopi ve besin alerjisi oranları (sırasıyla, p=0,04 ve p<0,001) ve Total IgE düzeyleri (p<0,01) hafif hastalardan daha yüksekti.
Sonuç: Orta/ağır şiddette atopik dermatitli çocuklarda semptomların sıklıkla erken süt çocukluğu döneminde geliştiği, besin alerjisinin daha sık eşlik ettiği ve Total IgE’nin daha yüksek olduğu göz önünde bulundurulmalı, hafif ve besin alerjisinin eşlik etmediği atopik dermatitli hastalarda gereksiz eliminasyon diyetinden kaçınılmalıdır.

Anahtar Kelimeler

• atopik dermatit
• hastalık şiddeti
• besin alerjisi

Kaynakça

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