Immunoglobulin E (IgE)-Mediated Food Allergy in Children: Epidemiology, Pathogenesis, Diagnosis, Prevention, and Management

Barni, Simona; Liccioli, Giulia; Sarti, Lucrezia; Giovannini, Mattia; Novembre, Elio; Mori, Francesca

doi:10.3390/medicina56030111

Cited by 59 publications

(45 citation statements)

References 91 publications

(106 reference statements)

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“…Fish allergy in children is a growing health concern, and the prevalence has been reported between 0% and 7% worldwide. The reactions can occur after ingestion, skin contact, or inhalation of the antigen and range from mild symptoms to life-threatening anaphylaxis [ 192 ]. Although a limited number of species have been analysed, parvalbumin, aldolase A, beta enolase, tropomyosin, collagen, vitellogenin have been identified as fish allergens.…”

Section: Resultsmentioning

confidence: 99%

IgE-Mediated Fish Allergy in Children

et al. 2021

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Fish allergy constitutes a severe problem worldwide. Its prevalence has been calculated as high as 7% in paediatric populations, and in many cases, it persists into adulthood with life-threatening signs and symptoms. The following review focuses on the epidemiology of Immunoglobulin E (IgE)-mediated fish allergy, its pathogenesis, clinical manifestations, and a thorough approach to diagnosis and management in the paediatric population. The traditional approach for managing fish allergy is avoidance and rescue medication for accidental exposures. Food avoidance poses many obstacles and is not easily maintained. In the specific case of fish, food is also not the only source of allergens; aerosolisation of fish proteins when cooking is a common source of highly allergenic parvalbumin, and elimination diets cannot prevent these contacts. Novel management approaches based on immunomodulation are a promising strategy for the future of these patients.

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Section: Resultsmentioning

confidence: 99%

IgE-Mediated Fish Allergy in Children

et al. 2021

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“…It is also interesting to highlight how 5.0% of patients who were not on elimination diets in our study had a reported food allergy. While elimination diets are indeed critical in AD patients with food allergy, it seems fundamental for pediatricians and dermatologists to promote an evidence-based management of suspected adverse reactions to food [ 25 – 27 ] based on a rigorous diagnostic allergy work-up carried out according to the current guidelines [ 28 ]. Indeed, an incorrect management of food allergy can lead to inappropriate and dangerous dietary restrictions - especially in children, who are very vulnerable to nutritional deficiencies [ 29 ] or to the risk of reactions [ 30 – 32 ].…”

Section: Discussionmentioning

confidence: 99%

Assessing patients’ characteristics and treatment patterns among children with atopic dermatitis

et al. 2021

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Background Atopic dermatitis (AD) is the most common immune-mediated skin disease in childhood. Several treatment options for pediatric AD, both topical and systemic, are currently available. We carried out a single-center observational study with the aim of describing characteristics and treatment patterns in pediatric AD patients. Methods The study included 867 patients aged ≤16 years (females 50.5%, mean patient’s age 5.9 years, standard deviation ±3.6 years) with a previous doctor-confirmed diagnosis of AD who underwent balneotherapy at the Comano Thermal Spring Water Center (Comano, Trentino, Italy) from April to October 2014. Results Among the patients included in the study, 41.2% had mild (SCORing Atopic Dermatitis, SCORAD 0-15), 43.6% moderate (SCORAD 16–40) and 15.2% severe AD (SCORAD > 40). A higher occurrence of reported food allergy was observed among children with more severe AD (p < 0.0001), while no association was found between AD severity and reported inhalant allergy or passive smoking (p = 0.15 and 0.92, respectively). Emollients (55.1%) and topical corticosteroids (TCS; 45.7%) were the main treatment options used in the previous month. The use of oral steroids and topical calcineurin inhibitors (TCI) was considerably less common (6.3 and 4.5%, respectively), while no patients were on systemic agents other than steroids. Among patients with severe AD, 9.8% had not used TCS, TCI or any systemic treatments. Moreover, 20.0% of the patients in the study population had followed elimination diets, although only 27.2% of them had a reported food allergy. Conclusions A significant difference in the prevalence of reported food allergy emerged across the different AD severity categories. Furthermore, although further data are necessary to confirm our findings, undertreatment in children with AD appeared to be very common, at least among those attending the Comano Thermal Spring Water Center. Moreover, many patients followed elimination diets in the absence of reported food allergy.

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“…NS can be associated with food allergies, which may be severe (71,72) and need proper management (73)(74)(75)(76). Specific oral tolerance induction could be used with an improved outcome in these patients in which an allergy is included in a broader genetic disorder (77,78).…”

Section: Management Of Complications and Comorbiditiesmentioning

confidence: 99%

Netherton Syndrome in Children: Management and Future Perspectives

et al. 2021

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Netherton syndrome (NS) is a genetic, multisystemic disease classically distinguished by a triad of clinical manifestations: congenital ichthyosiform erythroderma, hair shaft abnormalities, and immune dysregulation. Due to the complex pathogenesis of the disease, there are no specific therapies currently accessible for patients with NS. An early diagnosis is crucial to start the correct management of these patients. A multidisciplinary approach, including specialists in immunology, allergology, and dermatology, is necessary to set up the best therapeutic pathway. We conducted a review with the aim to summarize the different therapeutic strategies currently accessible and potentially available in the future for children with NS. However, given the limited data in the literature, the best-tailored management should be decided upon the basis of the specific clinical characteristics of the patients with this rare clinical condition. Further comprehension of the pathophysiology of the disease could lead to more efficacious specific therapeutic options, which could allow a change in the natural history of NS.

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Immunoglobulin E (IgE)-Mediated Food Allergy in Children: Epidemiology, Pathogenesis, Diagnosis, Prevention, and Management

Cited by 59 publications

References 91 publications

IgE-Mediated Fish Allergy in Children

IgE-Mediated Fish Allergy in Children

Assessing patients’ characteristics and treatment patterns among children with atopic dermatitis

Netherton Syndrome in Children: Management and Future Perspectives

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