IgE-mediated food allergy in children

Longo, Giorgio; Berti, Irene; Burks, A. Wesley; Krauss, Baruch; Barbi, Egidio

doi:10.1016/s0140-6736(13)60309-8

Cited by 158 publications

(165 citation statements)

References 107 publications

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“…The prevalence of special medical diets in this study was similar to the reported prevalence of food allergies in children (4)(5)(6)(7)(8)(9)(10). However, factors such as allergy definitions, methodologies and geographic variations influence the estimates, which make it difficult to accurately determine the prevalence of food allergies and to compare the rates between studies (23).…”

Section: Discussionsupporting

confidence: 78%

“…However, considering the previously shown large discrepancies between parent-reported and diagnosed food allergies (2,(4)(5)(6)(7)(8)(9)16,17), and the fact that many children on special medical diets lack medical certificates, some children may have been subjected to unnecessarily restricted diets. A potential way to avoid this may be the requirement for mandatory medical certificates for special diets for medical reasons, preferably with an appropriate time limit, for example for cows' milk and hens' egg allergies.…”

Section: Discussionmentioning

confidence: 99%

“…Food hypersensitivity includes food allergies, which are reactions of immunological origin, and nonimmunological intolerances such as lactose intolerance (3). Food allergy is a common and serious health problem in childhood (4,5). In developed countries, the estimated prevalence of true food allergy diagnosed by oral food challenge is approximately 3-8% in children (4)(5)(6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

“…Food allergy is a common and serious health problem in childhood (4,5). In developed countries, the estimated prevalence of true food allergy diagnosed by oral food challenge is approximately 3-8% in children (4)(5)(6)(7)(8)(9)(10). Adulttype lactose intolerance is thought to be uncommon in Sweden, at 2-3%, and symptoms do not typically develop before the age of four to five years (11,12).…”

Section: Introductionmentioning

confidence: 99%

“…There are large discrepancies between parent-reported and physician-diagnosed food hypersensitivity, which might lead to unnecessary diet restrictions with potential negative effects on nutrition during an important period of growth and development (2,(4)(5)(6)(7)(8)(9)(16)(17)(18)(19). Unnecessary special diets can also result in additional costs and efforts for families and the preschools and schools their children attend (20).…”

Section: Introductionmentioning

confidence: 99%

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Special diets are common among preschool children aged one to five years in south‐east Sweden according to a population‐based cross‐sectional survey

et al. 2017

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Aim: Information about the prevalence of special diets in preschool children is limited. The aim of this study was to measure the prevalence of all special diets among preschool children in a Swedish municipality.Methods: This was a population-based cross-sectional survey of all 3276 preschool children aged one to five years in the municipality of Karlskrona, Sweden. The questionnaire assessed the number of children at each preschool, how many were on special diets, their dietary requirements, age, sex, whether they had a medical certificate and whether the special diet had a perceived medical cause. Results:We obtained data for 3221 (98%) of the children, and 19% had special diets, including 12% on nonmedical diets and 6.3% on medical diets. The five most common diets were avoiding pork (7.8%), a vegetarian diet (4.8%), and avoiding cows' milk (3.5%), hens' eggs (1.2%) and lactose (1.1%). Gluten avoidance was more common in girls than boys (0.8% versus 0.2%, p = 0.032). Half (47%) of the children on special medical diets lacked a medical certificate.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Special diets are common among preschool children aged one to five years in south‐east Sweden according to a population‐based cross‐sectional survey

et al. 2017

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Hypersensitivity: IgE ‐Mediated (Type I )

Delves

2017

Encyclopedia of Life Sciences

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Hypersensitivity reactions, which are classified into 4 types (type I‐IV), are over‐zealous immune responses due to the fact that they are directed against harmless antigens, are of excessive magnitude, and/or are occurring in inappropriate body locations. Type I, or sometimes type IV, hypersensitivity reactions are responsible for the symptoms of allergy. Huge numbers of people suffer from allergic responses, which can vary in significance from being mildly inconvenient to resulting in rapid death. Allergic responses due to type I hypersensitivity are often referred to as atopic allergy and are mediated by the IgE class of antibody bound to tissue mast cells and to circulating blood basophils. Cross‐linking of the IgE by allergen results in the release of a plethora of inflammatory mediators that cause the symptoms. A variety of tests are available to assist in the diagnosis of type I hypersensitivity, and a range of therapies are used to control the diseases it causes. Key Concepts There are four main types of hypersensitivity reactions, which are characterised by inappropriate or exaggerated immune responses. Type I hypersensitivity reactions involve the activation of tissue mast cells and blood basophils when IgE molecules bound to their surface become linked together by an allergen. Substantial numbers of individuals develop allergies due to type I (IgE‐mediated) hypersensitivity, also referred to as atopic allergy. Allergies that are caused by type I hypersensitivity include hay fever, asthma, eczema and food allergy. The IgE antibodies are bound to the cell surface of the mast cells and basophils via a high affinity Fc receptor for IgE (FcϵR1). Susceptibility to the development of type I hypersensitivity has been linked to polymorphisms in several different genes. Activation of mast cells and basophils leads to the release of many different mediators of inflammation including histamine, prostaglandins and leukotrienes. The release of inflammatory mediators by mast cells and basophils is a component of normal immune responses, but in atopic allergy the response is inappropriate because it is against a substance that would not normally pose a threat. There are a number of different approaches to the treatment of atopic allergy, but the best strategy in individuals that have already become sensitised, and when feasible, is avoidance of re‐exposure to the allergen.

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Risk factors for discontinuing oral immunotherapy in children with persistent cow milk allergy

Benelli

Trombetta

Badina

et al. 2022

Immunity Inflam & Disease

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Background There are no universally accepted criteria for discontinuing milk oral immunotherapy (MOIT) in patients with persistent cow milk allergy (CMA) and little data are available on predictive risk factors for dropping out from oral immunotherapy (OIT), due to allergic reactions or other reasons. Methods We retrospectively reviewed clinical records of patients with persistent severe CMA undergoing MOIT in a tertiary care center hospital to investigate risk factors associated with discontinuation of OIT. Persistent and severe allergy was defined as the history of systemic reactions and any milk protein‐specific IgE level >85 kU/ml. All patients were first admitted for an in‐hospital rush phase eventually followed by an at‐home dose increase. We evaluated the effect of various factors on two primary outcomes: the highest dose of milk ingested during the in‐hospital rush phase and during the home OIT phase. Results We identified 391 patients, of whom 131 met the inclusion criteria for the retrospective study, 54 females and 77 males. Data of the home OIT phase were available for 104 patients (27%). Regarding the home OIT outcome, an association for having a cow milk avoiding diet was found with reaching a dose below 10 ml during the in‐hospital rush phase (relative risks [RR]: 2.33, confidence interval [CI]: 0.85; 6.42), an age above than 10 years from the time of admission (RR: 3.29, CI: 0.85; 12.73), and a higher total number of reactions occurred during the hospitalization (RR: 1.54, CI: 1.02; 2.32), whereas the presence of respiratory reactions with wheezing (RR: 1.93, CI: 0.49; 7.61) and an IM adrenaline use was related to a higher risk of having an OIT still in progress (RR: 5.47, CI: 0.33; 7.73). Conclusions In this cohort of children with persistent CMA undergoing OIT who presented with respiratory reactions with wheezing, the development of anaphylaxis with the need for IM adrenaline, and age above 10 years were predictors of poor long‐term outcome.

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IgE-mediated food allergy in children

Cited by 158 publications

References 107 publications

Special diets are common among preschool children aged one to five years in south‐east Sweden according to a population‐based cross‐sectional survey

Special diets are common among preschool children aged one to five years in south‐east Sweden according to a population‐based cross‐sectional survey

Hypersensitivity: IgE ‐Mediated (Type I )

Risk factors for discontinuing oral immunotherapy in children with persistent cow milk allergy

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