IgE mediated legume allergy in east Mediterranean children: A reflection of multiple food allergies


SOYAK AYTEKİN E., ÜNSAL H., ŞAHİNER Ü. M. , UYSAL SOYER Ö., ŞEKEREL B. E.

Pediatric Allergy and Immunology, vol.33, no.4, 2022 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 33 Issue: 4
  • Publication Date: 2022
  • Doi Number: 10.1111/pai.13775
  • Journal Name: Pediatric Allergy and Immunology
  • Journal Indexes: Science Citation Index Expanded, Scopus, Academic Search Premier, CAB Abstracts, EMBASE, Food Science & Technology Abstracts, MEDLINE, Veterinary Science Database
  • Keywords: bean, chickpea, legume allergy, lentil, Mediterranean region, pea, peanut, DIFFERENT SPECTRUM, CROSS-REACTIVITY, DIAGNOSIS, ANAPHYLAXIS, MANAGEMENT, PREVALENCE, GUIDELINES, CHICKPEA, PEANUT, RISK

Abstract

© 2022 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.Background: Legumes are nutritionally valuable as an inexpensive protein source, but may cause severe allergic reactions. This study aimed to identify the characteristics of legume allergies (LAs) in Turkish children. Methods: A total of 87 children (4.9 (3.1–7.0) years) with LAs confirmed by either oral food challenge (OFC) or consistent history were reviewed. Results: The median age of onset was 19 (12–38) months. The most frequent LA was lentil (n = 57, 66%), followed by peanut (n = 53, 61%), chickpea (n = 24, 28%), pea (n = 21, 24%), bean (n = 7, 8%), and soybean (n = 1, 1%). From these, it was observed that 60% had multilegume (≥2) allergies and the age of onset occurred earlier compared with the single LA subgroup (18 (11–30) vs. 28 (17–42) months, p =.042). Single LA was present in peanut (51%) and lentil (16%) allergies, but not chickpea, pea, and bean. Fifteen patients had tolerated lentils before their first allergic reaction. The majority of children with LA (91.9%) were allergic to multiple foods including tree nuts (71%), hen's egg (66%), and cow's milk (49%). Seventy-eight patients (89.7%) also presented with atopic comorbidities concerning atopic dermatitis (70%), asthma (40%), and allergic rhinitis (30%). Patients with anaphylactic type of reaction (20%) had higher frequency of aeroallergen sensitization (p =.001). Lip dose challenge with legume paste predicted the result of OFC with a diagnostic accuracy of 81.82% and a positive likelihood ratio of 10.8. Conclusion: In Turkey, LA is a reflection of multiple food allergies and the presence of allergy to a least frequently encountered legume is a sign of multiple LA.