Oral food challenge in IgE mediated food allergy in eastern Mediterranean children

The oral food challenge (OFC) in IgE mediated food allergy causes anxiety both in parents and in patients due to its inherent risks. Documentation of the rate, spectrum, and predictors of positive reactions is instructive. Children, who underwent OFC between January 1, 2017 and December 31, 2019 wer...

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Bibliographic Details
Published in:Allergologia et immunopathologia 2021-01, Vol.49 (3), p.185-192
Main Authors: Ünsal, Hilal, Bozat G, Gökçe Özyılmaz, Ocak, Melike, Akarsu, Ayşegül, Şahiner, Ümit Murat, Soyer, Özge, Şekerel, Bülent Enis
Format: Article
Language:eng ; spa
Subjects:
Age
Allergens
Anaphylaxis - etiology
Anaphylaxis - immunology
Asthma
Asthma - complications
Asthma - immunology
Child, Preschool
Confidence Intervals
Dermatitis
Egg Hypersensitivity - diagnosis
Egg Hypersensitivity - immunology
Epinephrine - therapeutic use
Female
Food allergies
Food Hypersensitivity - diagnosis
Food Hypersensitivity - immunology
Hay fever
Humans
Immunoglobulin E - immunology
Laboratories
Legumes
Male
Milk
Milk Hypersensitivity - diagnosis
Milk Hypersensitivity - immunology
Nut Hypersensitivity - diagnosis
Nut Hypersensitivity - immunology
Odds Ratio
Patients
Regression analysis
Rhinitis
Seeds
Seeds - immunology
Sesamum - immunology
Severity of Illness Index
Statistical analysis
Steroids
Time Factors
Wheat Hypersensitivity - diagnosis
Wheat Hypersensitivity - immunology
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Description
Summary:The oral food challenge (OFC) in IgE mediated food allergy causes anxiety both in parents and in patients due to its inherent risks. Documentation of the rate, spectrum, and predictors of positive reactions is instructive. Children, who underwent OFC between January 1, 2017 and December 31, 2019 were analyzed. A total of 1361 OFCs in 613 cases were reviewed. Most of them were performed in preschool children (≤2 years 50%) and 55% of them had more than one OFC. Mainly considered food groups were cow's milk (31.8%), hen's egg (28.5%), tree nuts (20%), legumes (7%), seeds (4.9%), and wheat (2.7%). The overall OFC positivity was 9.6%, whereas 6.7% with cow's milk, 4.9% with hen's egg, 16.1% with tree nuts, 21.6% with wheat, and 32.8% with seeds. The severity scoring revealed grade I (24.4%), II (45.8%), and III (29.7%) reactions. Fifty (38%) cases required epinephrine and four cases required hospitalization. OFCs with sesame seeds (odds ratio [OR]: 7.747, [confidence interval (CI) 95%: 4.03-14.90]), wheat (OR: 3.80, [CI: 1.64-8.84]), and tree nuts (OR: 2.78, [CI: 1.83-4.23]) predicted a positive OFC while a concomitant asthma (OR: 3.61 [CI: 1.27-10.28]) was more likely to elicit anaphylaxis. In OFC practice, priority is given to basic nutritional sources and the most frequent food allergens, where preschool children with multiple sensitizations are the primary subjects. Increased risks of positive reactions with sesame, tree nut, and wheat and increased risk of anaphylaxis with concomitant asthma should be considered while performing OFC.
ISSN:0301-0546
1578-1267
0301-0546
DOI:10.15586/aei.v49i3.189