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Prevalence of sensitivity to food and drug additives in patients with chronic idiopathic urticaria.
J Allergy Clin Immunol Pract. 2014 Mar-Apr; 2(2):168-71.JA

Abstract

BACKGROUND

Chronic idiopathic urticaria (CIU) is defined as the presence of urticaria most days of the week for a period of 6 weeks or longer. There have been reports of food additive sensitivity in CIU previously, but the prevalence has not been precisely determined.

OBJECTIVE

To determine the prevalence of reactions to food and drug additives in patients with CIU.

METHODS

We challenged 100 patients in our allergy/immunology division with CIU to the 11 additives most commonly associated with reactions: tartrazine (FD&C Yellow 5), potassium metabisulfite, monosodium glutamate, aspartame, sodium benzoate, methyl paraben, butylated hydroxy anisole, butylated hydroxy toluene, FD&C Yellow 6, sodium nitrate, sodium nitrite. All of the patients had a history of CIU for longer than 6 weeks, and 43 reported possible history of food or drug additive sensitivity. Single-blind challenges to all of the additives were performed in the clinic and skin scores were recorded. Subjects with positive challenge tests underwent double-blind placebo controlled challenges.

RESULTS

Of 100 subjects, only 2 had a positive urticarial response on single-blind challenge. Neither of these patients had a positive urticarial response on double-blind placebo-controlled challenge. There were no gastrointestinal, respiratory, or other symptom, and no patients reported late reactions.

CONCLUSION

We were able to conclude, with 95% confidence intervals that sensitivity to any of the 11 food and drug additives occurs in fewer than 1% of patients with CIU. Food and drug additives appear to be a rare cause of CIU, and avoidance is not recommended.

Authors+Show Affiliations

Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, Calif. Electronic address: rajan.jessica@scrippshealth.org.Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, Calif.Allergy & Asthma Consultants of Rockland and Bergen, West Nyack, NY.

Pub Type(s)

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

Language

eng

PubMed ID

24607044

Citation

Rajan, Jessica P., et al. "Prevalence of Sensitivity to Food and Drug Additives in Patients With Chronic Idiopathic Urticaria." The Journal of Allergy and Clinical Immunology. in Practice, vol. 2, no. 2, 2014, pp. 168-71.
Rajan JP, Simon RA, Bosso JV. Prevalence of sensitivity to food and drug additives in patients with chronic idiopathic urticaria. J Allergy Clin Immunol Pract. 2014;2(2):168-71.
Rajan, J. P., Simon, R. A., & Bosso, J. V. (2014). Prevalence of sensitivity to food and drug additives in patients with chronic idiopathic urticaria. The Journal of Allergy and Clinical Immunology. in Practice, 2(2), 168-71. https://doi.org/10.1016/j.jaip.2013.10.002
Rajan JP, Simon RA, Bosso JV. Prevalence of Sensitivity to Food and Drug Additives in Patients With Chronic Idiopathic Urticaria. J Allergy Clin Immunol Pract. 2014 Mar-Apr;2(2):168-71. PubMed PMID: 24607044.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of sensitivity to food and drug additives in patients with chronic idiopathic urticaria. AU - Rajan,Jessica P, AU - Simon,Ronald A, AU - Bosso,John V, Y1 - 2013/12/08/ PY - 2013/06/03/received PY - 2013/10/05/revised PY - 2013/10/08/accepted PY - 2014/3/11/entrez PY - 2014/3/13/pubmed PY - 2014/5/30/medline KW - Chronic idiopathic urticaria KW - Drug additives KW - Food additives SP - 168 EP - 71 JF - The journal of allergy and clinical immunology. In practice JO - J Allergy Clin Immunol Pract VL - 2 IS - 2 N2 - BACKGROUND: Chronic idiopathic urticaria (CIU) is defined as the presence of urticaria most days of the week for a period of 6 weeks or longer. There have been reports of food additive sensitivity in CIU previously, but the prevalence has not been precisely determined. OBJECTIVE: To determine the prevalence of reactions to food and drug additives in patients with CIU. METHODS: We challenged 100 patients in our allergy/immunology division with CIU to the 11 additives most commonly associated with reactions: tartrazine (FD&C Yellow 5), potassium metabisulfite, monosodium glutamate, aspartame, sodium benzoate, methyl paraben, butylated hydroxy anisole, butylated hydroxy toluene, FD&C Yellow 6, sodium nitrate, sodium nitrite. All of the patients had a history of CIU for longer than 6 weeks, and 43 reported possible history of food or drug additive sensitivity. Single-blind challenges to all of the additives were performed in the clinic and skin scores were recorded. Subjects with positive challenge tests underwent double-blind placebo controlled challenges. RESULTS: Of 100 subjects, only 2 had a positive urticarial response on single-blind challenge. Neither of these patients had a positive urticarial response on double-blind placebo-controlled challenge. There were no gastrointestinal, respiratory, or other symptom, and no patients reported late reactions. CONCLUSION: We were able to conclude, with 95% confidence intervals that sensitivity to any of the 11 food and drug additives occurs in fewer than 1% of patients with CIU. Food and drug additives appear to be a rare cause of CIU, and avoidance is not recommended. SN - 2213-2198 UR - https://www.unboundmedicine.com/medline/citation/24607044/Prevalence_of_sensitivity_to_food_and_drug_additives_in_patients_with_chronic_idiopathic_urticaria_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-2198(13)00392-9 DB - PRIME DP - Unbound Medicine ER -