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Diagnosis of IgE-mediated food allergy among Swiss children with atopic dermatitis.

Abstract

Diagnosis of food allergy in children with atopic dermatitis (AD) relies on a good knowledge of the prevalence of the disease and of the foods most frequently involved. Our objective was to define these characteristics in a population-of Swiss children with AD. Patients referred to a pediatric allergist or a dermatologist for AD were routinely tested by skin-prick test (SPT) to seven common food allergens (milk, egg, peanut, wheat, soy, fish, and nuts), and to all other foods suspected by history. Patients with positive SPTs were further evaluated for specific serum immunoglobulin E (IgE) antibodies (by using the CAP System FEIA ). CAP values were interpreted following previously published predictive values for clinical reactivity. Patients with inconclusive results (between the 95% negative predictive value [NPV] and the 95% positive predictive value [PPV]) were challenged with the suspected food. A total of 74 children with AD were screened for food allergies. Negative SPTs excluded the diagnosis in 30 subjects. Nineteen patients were diagnosed by histories suggestive of recent anaphylactic reactions to foods and/or CAP values above the 95% PPV. Forty-three food challenges (35 open challenges and eight double-blind, placebo-controlled in children with persistent lesions of AD despite aggressive topical skin treatment) were performed in patients with positive SPTs but with inconclusive CAP values. Six patients were diagnosed as positive to 15 foods. Challenges were not performed to high-allergenic foods in young children (under 12 months of age for egg and fish, and under 3 years of age for peanuts and nuts). Altogether, 33.8% (25 of 74) of the AD patients were diagnosed with food allergy. The prevalence of food allergy was 27% (seven of 25) in the group referred to the dermatologist for primary care of AD. The foods most frequently incriminated were egg, milk, and peanuts. The prevalence of food allergy in our population was comparable to that in other westernized countries, suggesting an incidence of food allergy in approximately one-third of children with persistent lesions of AD. Together with milk and eggs, peanuts were most frequently involved in allergic reactions.

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  • Authors+Show Affiliations

    ,

    Department of Pediatrics, University of Geneva School of Medicine, Switzerland. Philippe.Eigenman@hcuge.ch

    Source

    MeSH

    Adolescent
    Allergens
    Animals
    Arachis
    Child
    Child, Preschool
    Dermatitis, Atopic
    Female
    Fishes
    Food Hypersensitivity
    Humans
    Immunoglobulin E
    Infant
    Male
    Milk Hypersensitivity
    Prevalence
    Skin Tests
    Switzerland
    Triticum

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    10893011

    Citation

    Eigenmann, P A., and A M. Calza. "Diagnosis of IgE-mediated Food Allergy Among Swiss Children With Atopic Dermatitis." Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology, vol. 11, no. 2, 2000, pp. 95-100.
    Eigenmann PA, Calza AM. Diagnosis of IgE-mediated food allergy among Swiss children with atopic dermatitis. Pediatr Allergy Immunol. 2000;11(2):95-100.
    Eigenmann, P. A., & Calza, A. M. (2000). Diagnosis of IgE-mediated food allergy among Swiss children with atopic dermatitis. Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology, 11(2), pp. 95-100.
    Eigenmann PA, Calza AM. Diagnosis of IgE-mediated Food Allergy Among Swiss Children With Atopic Dermatitis. Pediatr Allergy Immunol. 2000;11(2):95-100. PubMed PMID: 10893011.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Diagnosis of IgE-mediated food allergy among Swiss children with atopic dermatitis. AU - Eigenmann,P A, AU - Calza,A M, PY - 2000/7/13/pubmed PY - 2001/2/28/medline PY - 2000/7/13/entrez SP - 95 EP - 100 JF - Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology JO - Pediatr Allergy Immunol VL - 11 IS - 2 N2 - Diagnosis of food allergy in children with atopic dermatitis (AD) relies on a good knowledge of the prevalence of the disease and of the foods most frequently involved. Our objective was to define these characteristics in a population-of Swiss children with AD. Patients referred to a pediatric allergist or a dermatologist for AD were routinely tested by skin-prick test (SPT) to seven common food allergens (milk, egg, peanut, wheat, soy, fish, and nuts), and to all other foods suspected by history. Patients with positive SPTs were further evaluated for specific serum immunoglobulin E (IgE) antibodies (by using the CAP System FEIA ). CAP values were interpreted following previously published predictive values for clinical reactivity. Patients with inconclusive results (between the 95% negative predictive value [NPV] and the 95% positive predictive value [PPV]) were challenged with the suspected food. A total of 74 children with AD were screened for food allergies. Negative SPTs excluded the diagnosis in 30 subjects. Nineteen patients were diagnosed by histories suggestive of recent anaphylactic reactions to foods and/or CAP values above the 95% PPV. Forty-three food challenges (35 open challenges and eight double-blind, placebo-controlled in children with persistent lesions of AD despite aggressive topical skin treatment) were performed in patients with positive SPTs but with inconclusive CAP values. Six patients were diagnosed as positive to 15 foods. Challenges were not performed to high-allergenic foods in young children (under 12 months of age for egg and fish, and under 3 years of age for peanuts and nuts). Altogether, 33.8% (25 of 74) of the AD patients were diagnosed with food allergy. The prevalence of food allergy was 27% (seven of 25) in the group referred to the dermatologist for primary care of AD. The foods most frequently incriminated were egg, milk, and peanuts. The prevalence of food allergy in our population was comparable to that in other westernized countries, suggesting an incidence of food allergy in approximately one-third of children with persistent lesions of AD. Together with milk and eggs, peanuts were most frequently involved in allergic reactions. SN - 0905-6157 UR - https://www.unboundmedicine.com/medline/citation/10893011/Diagnosis_of_IgE_mediated_food_allergy_among_Swiss_children_with_atopic_dermatitis_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0905-6157&date=2000&volume=11&issue=2&spage=95 DB - PRIME DP - Unbound Medicine ER -