Immunoglobulin E-Mediated Food Allergies Differ in East Mediterranean Children Aged 0-2 Years

KAHVECİ M., Koken G., ŞAHİNER Ü. M., Soyer Ö., ŞEKEREL B. E.

INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY, vol.181, no.5, pp.365-374, 2020 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 181 Issue: 5
  • Publication Date: 2020
  • Doi Number: 10.1159/000505996
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Agricultural & Environmental Science Database, BIOSIS, CAB Abstracts, EMBASE, Food Science & Technology Abstracts, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.365-374
  • Keywords: Atopic dermatitis, Breast feeding, Food allergy, Infant, Skin prick test panel, ATOPIC-DERMATITIS, YOUNG-CHILDREN, PREVALENCE, INFANTS, RISK, POPULATION, SENSITIZATION, EPIDEMIOLOGY, SEVERITY, ECZEMA
  • Hacettepe University Affiliated: Yes


Objective: Precise diagnosis of allergy requires knowledge of the population's food allergy (FA) spectrum and predictors. Methods: Medical charts of Turkish children aged 0-2 years with FA and/or atopic dermatitis (AD) were reviewed. Results: A total of 1,389 patients, 912 with FA and 1,140 with AD, were included. In the FA group, the most frequently diagnosed FAs were egg white (75.9%), cow's milk (55.7%), tree nuts (31.5%) and sesame (20.6%). The detection of FA in 99% of children with any kind of FA necessitate testing with egg white, cow's milk, hazelnut, sesame, walnut, cashew, and pistachio. In the FA group, 72.7 and 56.8% had AD and multiple FA respectively. Multiple FA (56.8 vs. 49.8%) and hen's egg allergy (85.5 vs. 50.2%, p < 0.005) were more common and cow's milk allergy (51.4 vs. 67.1%, p < 0.005) less common in the AD subgroup of the FA group than in the non-AD subgroup. Multiple FA likelihood increases parallel to the severity of AD (p < 0.05). In the AD group, 58.2% had an immunoglobulin E-mediated FA. The risk of concomitant FA increased as the age at symptom onset of AD decreased (OR 0.800 [95% CI 0.731-0.875]; p < 0.001) and the severity of AD increased (OR 2.350 [95% CI 1.898-2.911]; p < 0.001). Conclusion: Although severe and early-onset AD is a predictor of the presence and magnitude of FA in infancy, the spectrum of FA is a reflection of cultural characteristics. The clinical presentations of both AD and FA may in fact be an expression of the extent of the immune dysregulation underlying atopy and allergy.