Immunogloboulin E-Mediated Food Sensitization in Children with Celiac Disease: A Single-Center Experience

Abstract

Purpose Celiac disease (CD) is an autoimmune disorder of the small intestine caused by an abnormal immune response to gluten proteins and is often characterized by gastrointestinal symptoms. Food allergy (FA) is an adverse immune sensitivity to ingested food proteins leading to inflammation in various organs including the gastrointestinal tract. The relationship between CD and FA remains unclear. This study aimed to assess the prevalence and clinical relevance of immunoglobulin E (IgE)-mediated food sensitization in children with CD. Methods Fifty-nine children diagnosed with CD were reviewed for clinical symptoms and evidence of IgE-sensitization to food and airborne allergens using the PolyCheck method. Results IgE-mediated sensitization has been diagnosed in 20.3% of children with CD (CD/ A). In the CD/A group, 58.3% of children were sensitized to food and 66.7% to airborne allergens. Further, 41.7% of patients with CD and allergy reported gastrointestinal tract symptoms associated with the ingestion of sensitizing foods. Analysis of the clinical status revealed that the incidence of other allergic disorders in the CD/A group was as follows: atopic dermatitis (33.3%), asthma (25.0%), and allergic rhinitis (16.7%). The percentage of eosinophils was significantly higher in the CD/A group than in the CD group (0.33±0.25 vs. 0.11±0.09; p =0.006). Conclusion The diagnosis of CD does not exclude FA. The gastrointestinal symptoms in children with CD may be the result of both CD and FA; therefore, children with CD should be evaluated for the presence of FA regardless of age.

IgE-Dependent Allergy in Patients with Celiac Disease: A Systematic Review

“…An analysis of six original studies ( Table 2 ) revealed a possible coexistence of CD and A-IgE in four of them; however, two of them did not confirm this correlation. Among the papers confirming the possibility of an A-IgE occurrence in subjects with CD, two papers concerned allergies [ 14 , 15 ] and another two concerned sensitization [ 12 , 16 ]. Among the studies included in the analysis, there were four prospective [ 14 , 15 ] and two retrospective research studies [ 12 , 16 ].…”

“…Among the papers confirming the possibility of an A-IgE occurrence in subjects with CD, two papers concerned allergies [ 14 , 15 ] and another two concerned sensitization [ 12 , 16 ]. Among the studies included in the analysis, there were four prospective [ 14 , 15 ] and two retrospective research studies [ 12 , 16 ]. Five of the six studies were conducted in Europe [ 12 , 14 , 15 , 17 , 18 ].…”

“…Among the studies included in the analysis, there were four prospective [ 14 , 15 ] and two retrospective research studies [ 12 , 16 ]. Five of the six studies were conducted in Europe [ 12 , 14 , 15 , 17 , 18 ]. The study groups varied significantly and included 57 to 1044 people with CD [ 14 , 15 ].…”

“…The clinical symptoms and biochemical abnormalities ameliorate after an elimination diet in both conditions [ 4 ]. A lifelong gluten-free diet and a diet with the temporary elimination of harmful food allergens are prescribed for CD and FA, respectively [ 12 ].…”

The Most Common Allergens in Pediatric Patients in Iraq

“…Allergic children age range 1 to 10 years old from many clinics in Al-Najaf City, Iraq. The pediatric penal kit Polycheck®-Diagnostics (Germany) was used to reveal to the sensitivity of 20 different allergens (9) : Peanut, milk, egg white, egg yolk, potatoes, carrot, cod fish, apple, soya beans, wheat flour, birch pollen, timothy grass pollen, mugwort pollen, D. pteronyssinus, D. Farinae, dog epithelia, cat epithelia, horse epithelia and Cladosporium harbarum. Table (1) showed test measurement the concentration in (Ku/L) for IgE antibodies against any of the above allergens and the concentrations then converted into scores according.…”