A rising prevalence of food hypersensitivity (FHS) and severe allergic reactions to food has been reported the last decade. To estimate the prevalence of FHS to the most common allergenic foods in an ...unselected population of children and adults. We investigated a cohort of 111 children <3 yr of age, 486 children 3 yr of age, 301 children older than 3 yr of age and 936 adults by questionnaire, skin prick test, histamine release test and specific immunoglobulin E followed by oral challenge to the most common allergenic foods. In total, 698 cases of possible FHS were recorded in 304 (16.6%) participants. The prevalence of FHS confirmed by oral challenge was 2.3% in the children 3 yr of age, 1% in children older than 3 yr of age and 3.2% in adults. The most common allergenic foods were hen's egg affecting 1.6% of the children 3 yr of age and peanut in 0.4% of the adults. Of the adults, 0.2% was allergic to codfish and 0.3% to shrimp, whereas no challenges with codfish and shrimp were positive in the children. The prevalence of clinical reactions to pollen‐related foods in pollen‐sensitized adults was estimated to 32%. This study demonstrates the prevalence of FHS confirmed by oral challenge to the most common allergenic foods in an unselected population of children and adults.
A rising prevalence of food hypersensitivity (FHS) and severe allergic reactions to foods have been reported in the last decade. However, little is known on the prevalence in young adults. This study ...estimated the prevalence of FHS to the most common allergenic foods in an unselected population of young adults. We investigated a cohort of 1272 young adults 22 years of age by questionnaire, skin prick test (SPT) and histamin release (HR) followed by oral challenge to the most common allergenic foods. FHS was divided into primary and secondary FHS. Primary FHS was defined as being independent of pollen sensitization, whereas secondary FHS was defined as reactions to pollen related fruits and vegetables in pollen allergic patients. The questionnaire was returned by 77.1%. Primary FHS was reported by 19.6% and secondary FHS by 16.7% of the participants. Confirmed primary FHS by oral challenge was 1.7% 1.1% ‐ 2.95%. In primary FHS, the most common allergenic food was peanut (0.6%) followed by additives (0.5%), shrimp (0.2%), codfish (0.1%), cow’s milk (0.1%), octopus (0.1%) and soy (0.1%). In secondary FHS, kiwi allergy was reported by 7.8% of the participants followed by hazelnut (6.6%), pineapple (4.4%), apple (4.3%), orange (4.2%), tomato (3.8%), peach (3.0%) and brazil nut (2.7%). This study found a 1.7% 1.1% ‐ 2.95% prevalence of primary FHS confirmed by oral challenge to the most common allergenic foods in an unselected population of young adults.
Background: Previous studies have described cross‐reactivity between fresh fruits, vegetables and pollen. However, no data demonstrates the clinical relevance of sensitization to pollen‐related ...fruits and vegetables in unselected pollen‐sensitized adults with and without symptoms in the pollen season.
Objective: The aim of this study was to estimate the clinical relevance of sensitization to pollen‐related fruits and vegetables in unselected pollen‐sensitized adults and to examine the diagnostic value of skin‐prick test (SPT), histamine release and specific IgE compared with the outcome of oral challenge.
Methods: In total, 936 unselected adults (female : male 479 : 457, median age 33.7 years) were examined for pollen sensitization and clinical cross‐reactivity with pollen‐related fruits and vegetables by questionnaire, SPT, histamine release, specific IgE and oral challenge.
Results: The prevalence of pollen sensitization was 23.8% (n = 223). The probability of a clinical reaction to pollen‐related foods in the respective pollen‐sensitized groups was: 24% (birch), 4% (grass), 10% (mugwort), 35% (birch + grass), 8% (grass + mugwort) and 52% (birch + grass + mugwort). The odds ratio of a clinical reaction to pollen‐related fruits and vegetables in symptomatic pollen‐sensitized adults was as high as four times (birch + grass) the odds ratio of a clinical reaction in asymptomatic pollen‐sensitized adults.
Conclusion: This study not only demonstrates a high prevalence of clinical reactions to fruits and vegetables in pollen‐sensitized adults, but also a discrepancy between the prevalence of sensitization to fruits and vegetables and the clinical relevance in different pollen‐sensitized groups with symptoms in the pollen season as a significant factor.
The aim of this paper was to investigate whether a statistical model could be developed to estimate a "threshold" dose for foods eliciting allergic reactions in susceptible patients. The threshold ...dose is defined to be one that elicits allergic reactions in a given (small) proportion of susceptible patients, using data from published studies.
Based on data available from the literature, we developed a statistical model using the actual allergen content in the four foods, where data for allergen content are available (peanut, soy, egg, milk).
The model demonstrated that the threshold doses giving a reaction of one in a million in susceptible patients were within the same order of magnitude for egg, milk and soy, but were an order of magnitude lower for peanut flour: 0.005 mg of cow's milk, 0.002 mg of fresh hen's egg, 0.0007 mg of peanut, or 0.0013 mg of soy flour.
Although several assumptions were made in creating this statistical model, we demonstrated that the previously published differences in threshold doses for various foods can be largely eliminated by comparing actual allergen content; this may therefore serve as a model for further studies.
Background: The aim of the study was to examine the diagnostic value of skin prick test (SPT), scratch‐chamber test (SCT), histamine release (HR) and specific immunoglobulin E (IgE) in birch‐allergic ...patients with oral allergy syndrome to apple.
Methods: Ten birch‐allergic patients with oral allergy syndrome to apple and 10 control subjects were included. All were tested with SPT, SCT, HR and specific IgE CAP, Pharmacia, Sweden and Magic Lite (ML), ALK‐ABELLÓ, Denmark.
Results: The SPT with apple, acetone extract of apple (A72) and commercial apple extract showed sensitivities of 0.80, 0.90 and 0.10, respectively.
The SCT with the same extracts showed sensitivities of 0.30, 0.50 and 0.20, respectively. The sensitivity of specific IgE to apple were 0.90 (CAP) and 0.10 (ML).
The sensitivity of the HR test was 90% (A72), and 25% using the commercial extract.
Conclusion: The SPT and HR test with apple and A72 showed a good diagnostic value with a sensitivity of more than 70% and a specificity of 100%.
The SCT showed a poor sensitivity to apple, A72 and commercial apple extract. The ML test was not suitable in detecting specific IgE to apple compared with the CAP test.
In daily practice a detailed case history about symptoms of oral allergy syndrome combined with a SPT with fresh apple peel or A72 will be useful.
Background: Previously published articles described a relationship between food-specific IgE and the outcome of food challenge in children with egg allergy. These investigations defined different ...levels of predictive values in different study populations and thus pointed toward the possibility of a certain level of specific IgE to egg white predicting a positive outcome in food challenge. Objective: The purpose of this study was to determine the utility of specific IgE in estimating threshold level to predict a positive outcome in food challenge. Methods: Fifty-six children were evaluated for egg allergy by titrated oral challenges. Sera were analyzed for specific IgE to egg white in 56 patients by using the Magic Lite test and 32 of 56 patients also by the CAP test. Values of specific IgE to egg white were compared to the outcome of challenges and the threshold level. Results: The diagnostic level of specific IgE predicting clinical reactivity in this population with greater than 95% certainty was identified as 10.8 standardized units/mL (Magic Lite) and 1.5 kilounits of allergen-specific IgE/L (CAP), respectively. We found no significant relationship between the specific IgE concentration (egg white) and the challenge threshold level. Conclusion: Although the specific IgE concentration correlated to a positive outcome in food challenge, there was no significant relationship between the quantification of specific IgE and the challenge threshold level. Therefore the standardized food challenge still remains the gold standard in the diagnosis of food allergy. (J Allergy Clin Immunol 2003;112:196-201.)
Previous studies have suggested that the atopy patch test (APT) may make oral challenge superfluous in diagnosing children with food hypersensitivity.
To investigate the clinical relevance of APT in ...predicting hypersensitivity to cow's milk and hen's egg in 486 unselected children 3 years of age.
The children were examined by APT, skin prick (SPT), histamine release (HR), and specific IgE followed by oral challenge when hypersensitivity to cow's milk or hen's egg was suspected.
Food hypersensitivity confirmed by oral challenge was 1.6% to hen's egg and 0.6% to cow's milk. No hypersensitivity to cow's milk or hen's egg was predicted by APT alone.
APT could not predict food hypersensitivity not predicted by SPT, HR, or specific IgE. Thus, APT cannot be recommended in daily practice for the diagnosis of hypersensitivity to cow's milk and hen's egg in children 3 years of age.
How many people suffer from allergies? Osterballe, Morten; Linneberg, Allan R
Ugeskrift for læger,
2005-Feb-07, Letnik:
167, Številka:
6
Journal Article
