Diagnosis of IgE‐mediated food allergy among Swiss children with atopic dermatitis

Eigenmann, Philippe; Calza, Anne‐Marie

doi:10.1034/j.1399-3038.2000.00071.x

Cited by 151 publications

(90 citation statements)

References 17 publications

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“…The combination of early, non-eczematous reactions (urticaria, pruritus, and oral allergy syndrome) followed by late-phase flares of eczema is presumably more common; however, the challenge-regimen with massive loading of allergen could prevent this as challenges will be terminated after the initial symptoms. We found that 18 of 122 (14.8%) children with AD had FHS, whereas previous studies have reported more than 30% (4,(8)(9)(10). However, these studies were mainly conducted on selected children recruited from university clinics.…”

Section: Frequency and Relevance Of Sensitizationcontrasting

confidence: 48%

Food allergy and food sensitization in early childhood: results from the DARC cohort

Eller¹,

Kjær²,

Høst

et al. 2009

Allergy

152

121

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Background: The prevalence of food hypersensitivity (FHS) and the relationship with atopic dermatitis (AD) is controversial. The aim of this study was to determine the development of FHS and to correlate this with AD in relation to sensitization and symptoms.Methods: This study combines new data from birth to 18 months of age with previous published results from 3 and 6 years. The Danish Allergy Research Centre cohort, including 562 children, is a unique, population‐based, prospective birth cohort, with clinical examinations at all follow‐ups. All children were examined for the development of AD using Hanifin‐Rajka criteria and for FHS using interviews, skin prick test (SPT), specific immunoglobulin E (IgE), and food challenge according to EAACI guidelines.Results: Twenty children were confirmed with FHS to milk, egg, and peanut. FHS peaked at 18 months (3.6%) and then decreased to 1.2% at 72 months of age. No new cases were found after 3 years. Self‐reporting could only be confirmed in 31% of cases. Among the 122 children with AD, 18 had FHS (14.8%). FHS was IgE‐mediated in 95% of the cases but 16 of 20 children were additionally sensitized to other foods which they tolerated. Children with AD were neither more IgE‐sensitized nor had higher levels of IgE when compared with healthy children but they were more persistently sensitized.Conclusions: Sensitization to foods in young children without food allergy seems to be a normal phenomenon. The discrepancy between sensitization, self‐reported food‐related symptoms and confirmed FHS illustrates the need to perform standardized oral challenges in order to confirm the diagnosis of FHS.

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Section: Frequency and Relevance Of Sensitizationcontrasting

confidence: 48%

Food allergy and food sensitization in early childhood: results from the DARC cohort

Eller¹,

Kjær²,

Høst

et al. 2009

Allergy

152

121

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“…Deri geçirgenliğinin artması sonucu allerjenlerin daha kolay penetrasyonu ile IgE aracılı sensitizasyon gerçekleşir. Genetik olarak yatkın bireylerde başlayan AD'e infantil çağda %30-60 arasında değişen oranda IgE aracılıklı besin allerjisi eşlik eder (7,8). Bebeklik ve çocukluk yaş grubunda süt, yumurta, buğday, soya, yer fıstığı, fındık gibi besin allerjenleri AD alevlenmelerini tetikleyebilirler (9).…”

Section: Introductionunclassified

Food Hypersensitivity in Atopic Dermatitis During Infancy: Skin Prick Testing for Whom?

Emeksiz

Cavkaytar

Aksoy

et al. 2017

Asthma Allergy Immunol

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ÖZGiriş: Atopik dermatit (AD) bebeklik döneminde sık görülen bir hastalıktır. Yaşamın ilk 6 ayında, özellikle ilk 3 ayında başvuran AD'li hastalarda besin duyarlılığı konusunda veri kısıtlıdır. Çalışmada AD tanısı almış bebeklerde başvuru zamanına göre besin duyarlılığı(BD) sıklığının ve ilişkili faktörlerin ortaya konulması amaçlanmıştır.Gereç ve Yöntem: Çalışmamıza S.B. Ankara Eğitim Araştırma Hastanesi Çocuk Allerji ve İmmünoloji Kliniği'ne başvuran AD'li bir yaşından küçük hastalar dahil edildi. Hastaların demografik özellikleri, beslenme durumları, hastalık şiddetleri, deri testi sonuçları kaydedildi. Besin duyarlılığı tanısı varlığında besin deri testi pozitifliği ile kondu. Deri testi pozitif olan hastaların tümü ilgili besinin diyetten eliminasyonundan fayda gördü. Bulgular: Çalışmaya 110 (%70'i erkek) hasta alındı, 23 (%21.6) bebek BD tanısı aldı. Üç aylık ve daha küçük AD'li hastalarda BD olanlarda olmayanlara göre SCORAD indeksi [(25.2 (20.9-34.9 Sonuç: Üç aylık ve daha küçük AD'li bebeklerde serum total IgE düzeyi ve SCORAD indeksi, 3-6 ay arasında ise ek olarak eozinofil ABSTRACT Objective: Atopic dermatitis (AD) is a common disease during infancy. The data on food hypersensitivity (FH) in the first six months and especially in the first three months of life is limited in children with AD. The aim of this study was to find out the frequency of FH and related factors in infants with AD in regard to their referral age. Materials and Methods:Infants younger than 1 years of age who were diagnosed as AD at the Ankara Training and Research Hospital's Department of Pediatrics were included in our study. The demographic features, nutritional status, disease severity and skin test results were recorded. A diagnosis of FH was made in the presence of a positive skin test with the related allergen. All the patients with FH had resolution of the symptoms with the elimination of the relevant food from the diet.Results: One-hundred and ten patients (70% male) were included. In patients younger than 3 months of age, the SCORAD-index and total IgE levels were higher in the patients with FH compared to patients without FH [(25.2(20.9-34.9) vs. 19.2(13.1-24.2), (p=0.034) and 22.2(11.6-52.6)kU/L vs. 4(4-10)kU/L, (p=0.04), respectively]. In patients aged between 3 and 6 months of age, the SCORAD index, total IgE and eosinophil levels were higher in patients with FH compared to patients without .7), (p<0.001)], [42.1(6.3-283)kU/L vs. 8.3(4.8-8.3)kU/L, (p=0.033)], [7.5%(3.9-9.7) vs. 3.5%(1.8-5.8), (p=0.01)]. In patients older than 6 months of age, the SCORAD index, eosinophil and IgE levels were similar between patients with and without FH.

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“…SPTs usually have sufficient sensitivity and specificity to be the sole method of skin testing necessary for most clinical scenarios. In general, SPTs have a sensitivity of *90 % but a specificity of only about 50 % [22]. An important component of management is the understanding by clinicians of the predictive value of individual FA tests.…”

Section: In Vivo Testsmentioning

confidence: 99%

“…An important component of management is the understanding by clinicians of the predictive value of individual FA tests. The larger the size of the wheal on a skin test, the more likely a patient will react to the food (Table 2) [12,22,23]. The quality and allergen content of the extract employed for the test are pivotal.…”

Section: In Vivo Testsmentioning

confidence: 99%

Diagnosing and Treating Food Allergy

et al. 2013

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Food allergy (FA) is defined as an abnormal immunological reaction to food proteins. Over 90 % of FAs in childhood are caused by eight foods: cow's milk, hen's egg, soy, peanuts, tree nuts, wheat, fish and shellfish. The diagnostic work up for a child with suspected FA includes detailed medical history, physical examination, FA screening tests and response to elimination diet and to oral food challenge. Sometimes additional diagnostic tools to explore intestinal damage and function could be adopted. Currently, the only treatment for FA relies on strict elimination diets supervised by the nutritionist. Main new therapeutic strategies for FA include allergen-specific (oral, sublingual, epicutaneous, subcutaneous immunotherapy and heat treatment of food) and nonallergen-specific therapies (humanized monoclonal antibodies, anti-IgE and anti-IL5, probiotics). An incorrect diagnosis is likely to result in unnecessary dietary restrictions, which, if prolonged, may adversely affect the child's nutritional status and growth.

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Diagnosis of IgE‐mediated food allergy among Swiss children with atopic dermatitis

Cited by 151 publications

References 17 publications

Food allergy and food sensitization in early childhood: results from the DARC cohort

Food allergy and food sensitization in early childhood: results from the DARC cohort

Food Hypersensitivity in Atopic Dermatitis During Infancy: Skin Prick Testing for Whom?

Diagnosing and Treating Food Allergy

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