Klinik Araştırma
BibTex RIS Kaynak Göster

Evaluation of Clinical Features of Pediatric Patients with Wheat Sensitivity

Yıl 2024, Cilt: 18 Sayı: 3, 181 - 185, 13.05.2024
https://doi.org/10.12956/tchd.1425845

Öz

Objective: This study aimed to determine the frequency of true wheat allergy among pediatric patients with wheat sensitivity detected by skin prick test (SPT) in our center and to evaluate the clinical features and prognosis of the patients.

Material and Methods: This study was conducted with 63 patients who were found to have wheat sensitivity on skin prick test (SPT) between January 2017 and May 2023 in the Pediatric Allergy and Immunology Clinic of our hospital.Demographic and clinical characteristics, oral provocation tests (OPT) and prognosis of these patients were analyzed.

Results: In 9432 food SPTs, wheat positivity was detected in 63 patients and the wheat sensitivity rate was found to be 0.6%. Sixty-one point nine percent of these patients were girls. In patients with wheat atopy, 55.5% were infants between 0-6 months of age. Out of 63 patients, six (9.5%) presented with a history suggestive of IgE-mediated reaction, while 57 (90.5%) presented with a history suggestive of atopic dermatitis. Among these patients with a history of atopic dermatitis, 34 (59.6%) were found to have cow’s milk and egg atopy in addition to wheat sensitivity. Eczema exacerbation was observed in three patients on OPT performed after 2-4 weeks of short term elimination. These patients were able to consume wheat without any reaction after 6-12 months of elimination diet.

Conclusion: Wheat sensitivity not confirmed by oral provocation tests leads to unnecessary elimination of wheat, an essential nutrient. This shows the importance of OPT in patients with wheat atopy.

Kaynakça

  • Peters RL, Krawiec M, Koplin JJ, Santos AF. Update on food allergy. Pediatr Allergy Immunol 2021;32:647-57.
  • Savage J, Johns CB. Food allergy: epidemiology and natural history. Immunol Allergy Clin North Am 2015;35:45-59.
  • Inomata N. Wheat allergy. Curr Opin Allergy Clin Immunol 2009;9:238-43.
  • Ricci G, Andreozzi L, Cipriani F, Giannetti A, Gallucci M, Caffarelli C. Wheat allergy in children: a comprehensive update. Medicina 2019;55:400.
  • Elli L, Branchi F, Tomba C, Villalta D, Norsa L, Ferretti F, et al. Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity. World J Gastroenterol 2015;21:7110-9.
  • Immunology TNSoAaC. Buğday Yükleme Testleri. In: Saçkesen C, editor. Allergy. Türkiye: Buluş tasarım ve yayıncılık 2019;114-5.
  • Cianferoni A. Wheat allergy: diagnosis and management. J Asthma Allergy 2016:13-25.
  • El-Sayed ZA, Sakr H, Shousha GAH. Sensitivitys to wheat and strawberry: are they a tangible threat to atopic Egyptian. Am J Clin Exp Immunol 2022;11:84.-91
  • Czaja-Bulsa G, Bulsa M. What do we know now about IgE-mediated wheat allergy in children? Nutrients 2017;9:35.
  • Ünsal H, Ocak M, Akarsu A, Şahiner ÜM, Soyer Ö, Şekerel BE. Oral food challenge in IgE mediated food allergy in eastern Mediterranean children. Allergol Immunopathol (Madr) 2021;49:185-92.
  • Fukutomi Y, Taniguchi M, Nakamura H, Akiyama K. Epidemiological link between wheat allergy and exposure to hydrolyzed wheat protein in facial soap. Allergy 2014;6:1405-11.
  • Rutrakool N, Piboonpocanun S, Wangthan U, Srisuwatchari W, Thongngarm T, Jirapongsananuruk O, et al. Children with wheat anaphylaxis and with low wheat specific IgE have a different IgE immunoblot pattern than those with high wheat specific IgE. Asian Pac J Allergy Immunol 2023:2. doi: 10.12932/AP-140622-1387.
  • Srisuwatchari W, Vichyanond P, Jirapongsananuruk O, Visitsunthorn N, Pacharn P. Characterization of children with IgE-mediated wheat allergy and risk factors that predict wheat anaphylaxis. Asian Pac J Allergy Immunol 2022;40:263-8.
  • Samady W, Warren C, Kohli S, Jain R, Bilaver L, Mancini AJ, et al. The prevalence of atopic dermatitis in children with food allergy. Ann Allergy Asthma Immunol 2019;122:656-7. e1.
  • Singh AM, Anvari S, Hauk P, Lio P, Nanda A, Sidbury R, et al. Atopic dermatitis and food allergy: best practices and knowledge gaps—a work group report from the AAAAI Allergic Skin Diseases Committee and Leadership Institute Project. J Allergy Clin Immunol Pract 2022;10:697-706.
  • Mavroudi A, Karagiannidou A, Xinias I, Cassimos D, Karantaglis N, Farmaki E, et al. Assessment of IgE-mediated food allergies in children with atopic dermatitis. Allergol Immunopathol 2017;45:77-81.
  • Keet CA, Matsui EC, Dhillon G, Lenehan P, Paterakis M, Wood RA. The natural history of wheat allergy. Ann Allergy Asthma Immunol 2009;102:410-5.
  • Quirce S, Boyano-Martínez T, Díaz-Perales A. Clinical presentation, allergens, and management of wheat allergy. Expert Rev Clin Immunol 2016;12:563-72

Buğday Duyarlılığı Saptanan Çocuk Hastaların Klinik Özelliklerinin Değerlendirilmesi

Yıl 2024, Cilt: 18 Sayı: 3, 181 - 185, 13.05.2024
https://doi.org/10.12956/tchd.1425845

Öz

Amaç: Bu çalışma ile merkezimizde deri prick testi (DPT) ile buğday atopisi saptanan çocuk hastalar içinde gerçek buğday alerjisi sıklığının belirlenmesi, hastaların klinik özelliklerinin ve prognozlarının değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntemler: Bu çalışma hastanemiz Çocuk Alerji ve İmmünoloji Kliniği’nde Ocak 2017 ile Mayıs 2023 tarihleri arasında deri prick test (DPT)’ lerinde buğday atopisi saptanan 63 hasta ile yapılmıştır. Bu hastaların demografik ve klinik özellikleri, oral provokasyon testleri (OPT) ve prognozları incelenmiştir.

Bulgular: Yapılan 9432 besin DPT’nde 63 hastada buğday pozitifliği saptandı ve buğday atopi oranı %0.6 olarak bulundu. Bu hastaların %61.9’u kızdı. Buğday atopisi saptanan hastaların %55.5’i 0-6 ay arasındaki süt çocuklarından oluşmaktaydı. Altmış üç hastandan altı (%9.5)’i IgE aracılıklı reaksiyon düşündüren öykü ile, 57 (%90.5)’i ise atopikdermatit düşündüren öykü ile başvurmuştu. Atopik dermatit öyküsü olan bu hastalardan 34 (%59.6)’sında buğday atopisine ek olarak inek sütü ve yumurta atopisi de saptandı. İki ile dört haftalık kısa eliminasyondan sonra yapılan OPT’ de üç hastada egzama alevlenmesi görüldü. Bu hastalar 6-12 aylık eliminasyon diyeti sonrasında buğdayı sorunsuz bir şekilde tüketebildi.

Sonuç: Oral provokasyon testleri ile doğrulanmayan buğday atopisi, temel besin maddesi olan buğdayın gereksiz eliminasyonuna neden olmaktadır. Bu durum buğday atopisi olan hastalarda OPT’nin önemini göstermektedir.

Kaynakça

  • Peters RL, Krawiec M, Koplin JJ, Santos AF. Update on food allergy. Pediatr Allergy Immunol 2021;32:647-57.
  • Savage J, Johns CB. Food allergy: epidemiology and natural history. Immunol Allergy Clin North Am 2015;35:45-59.
  • Inomata N. Wheat allergy. Curr Opin Allergy Clin Immunol 2009;9:238-43.
  • Ricci G, Andreozzi L, Cipriani F, Giannetti A, Gallucci M, Caffarelli C. Wheat allergy in children: a comprehensive update. Medicina 2019;55:400.
  • Elli L, Branchi F, Tomba C, Villalta D, Norsa L, Ferretti F, et al. Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity. World J Gastroenterol 2015;21:7110-9.
  • Immunology TNSoAaC. Buğday Yükleme Testleri. In: Saçkesen C, editor. Allergy. Türkiye: Buluş tasarım ve yayıncılık 2019;114-5.
  • Cianferoni A. Wheat allergy: diagnosis and management. J Asthma Allergy 2016:13-25.
  • El-Sayed ZA, Sakr H, Shousha GAH. Sensitivitys to wheat and strawberry: are they a tangible threat to atopic Egyptian. Am J Clin Exp Immunol 2022;11:84.-91
  • Czaja-Bulsa G, Bulsa M. What do we know now about IgE-mediated wheat allergy in children? Nutrients 2017;9:35.
  • Ünsal H, Ocak M, Akarsu A, Şahiner ÜM, Soyer Ö, Şekerel BE. Oral food challenge in IgE mediated food allergy in eastern Mediterranean children. Allergol Immunopathol (Madr) 2021;49:185-92.
  • Fukutomi Y, Taniguchi M, Nakamura H, Akiyama K. Epidemiological link between wheat allergy and exposure to hydrolyzed wheat protein in facial soap. Allergy 2014;6:1405-11.
  • Rutrakool N, Piboonpocanun S, Wangthan U, Srisuwatchari W, Thongngarm T, Jirapongsananuruk O, et al. Children with wheat anaphylaxis and with low wheat specific IgE have a different IgE immunoblot pattern than those with high wheat specific IgE. Asian Pac J Allergy Immunol 2023:2. doi: 10.12932/AP-140622-1387.
  • Srisuwatchari W, Vichyanond P, Jirapongsananuruk O, Visitsunthorn N, Pacharn P. Characterization of children with IgE-mediated wheat allergy and risk factors that predict wheat anaphylaxis. Asian Pac J Allergy Immunol 2022;40:263-8.
  • Samady W, Warren C, Kohli S, Jain R, Bilaver L, Mancini AJ, et al. The prevalence of atopic dermatitis in children with food allergy. Ann Allergy Asthma Immunol 2019;122:656-7. e1.
  • Singh AM, Anvari S, Hauk P, Lio P, Nanda A, Sidbury R, et al. Atopic dermatitis and food allergy: best practices and knowledge gaps—a work group report from the AAAAI Allergic Skin Diseases Committee and Leadership Institute Project. J Allergy Clin Immunol Pract 2022;10:697-706.
  • Mavroudi A, Karagiannidou A, Xinias I, Cassimos D, Karantaglis N, Farmaki E, et al. Assessment of IgE-mediated food allergies in children with atopic dermatitis. Allergol Immunopathol 2017;45:77-81.
  • Keet CA, Matsui EC, Dhillon G, Lenehan P, Paterakis M, Wood RA. The natural history of wheat allergy. Ann Allergy Asthma Immunol 2009;102:410-5.
  • Quirce S, Boyano-Martínez T, Díaz-Perales A. Clinical presentation, allergens, and management of wheat allergy. Expert Rev Clin Immunol 2016;12:563-72
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri (Diğer)
Bölüm ORIGINAL ARTICLES
Yazarlar

Gökhan Yörüsün 0000-0002-0558-7192

Funda Aytekin Güvenir 0000-0002-2703-8055

Ragıp Dere 0000-0003-2218-5854

Zeynep Sengul Emeksiz 0000-0001-7648-0352

Emine Dibek Mısırlıoğlu 0000-0002-3241-2005

Erken Görünüm Tarihi 3 Nisan 2024
Yayımlanma Tarihi 13 Mayıs 2024
Gönderilme Tarihi 26 Ocak 2024
Kabul Tarihi 1 Mart 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 18 Sayı: 3

Kaynak Göster

Vancouver Yörüsün G, Aytekin Güvenir F, Dere R, Sengul Emeksiz Z, Dibek Mısırlıoğlu E. Evaluation of Clinical Features of Pediatric Patients with Wheat Sensitivity. Türkiye Çocuk Hast Derg. 2024;18(3):181-5.

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