Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Int Arch Allergy Immunol. 2020;181(5):365-374. doi: 10.1159/000505996. Epub 2020 Feb 25.
Precise diagnosis of allergy requires knowledge of the population's food allergy (FA) spectrum and predictors.
Medical charts of Turkish children aged 0-2 years with FA and/or atopic dermatitis (AD) were reviewed.
A total of 1,389 patients, 912 with FA and 1,140 with AD, were included. In the FA group, the most frequently diagnosed FAs were egg white (75.9%), cow's milk (55.7%), tree nuts (31.5%) and sesame (20.6%). The detection of FA in 99% of children with any kind of FA necessitate testing with egg white, cow's milk, hazelnut, sesame, walnut, cashew, and pistachio. In the FA group, 72.7 and 56.8% had AD and multiple FA respectively. Multiple FA (56.8 vs. 49.8%) and hen's egg allergy (85.5 vs. 50.2%, p < 0.005) were more common and cow's milk allergy (51.4 vs. 67.1%, p < 0.005) less common in the AD subgroup of the FA group than in the non-AD subgroup. Multiple FA likelihood increases parallel to the severity of AD (p < 0.05). In the AD group, 58.2% had an immunoglobulin E-mediated FA. The risk of concomitant FA increased as the age at symptom onset of AD decreased (OR 0.800 [95% CI 0.731-0.875]; p < 0.001) and the severity of AD increased (OR 2.350 [95% CI 1.898-2.911]; p < 0.001).
Although severe and early-onset AD is a predictor of the presence and magnitude of FA in infancy, the spectrum of FA is a reflection of cultural characteristics. The clinical presentations of both AD and FA may in fact be an expression of the extent of the immune dysregulation underlying atopy and allergy.
准确诊断过敏需要了解人群的食物过敏（FA）谱和预测因素。
回顾了土耳其 0-2 岁儿童 FA 和/或特应性皮炎（AD）的病历。
共纳入 1389 例患者，其中 912 例 FA，1140 例 AD。在 FA 组中，最常诊断的 FA 是蛋清（75.9%）、牛奶（55.7%）、坚果（31.5%）和芝麻（20.6%）。99%有任何类型 FA 的儿童均需进行蛋清、牛奶、榛子、芝麻、核桃、腰果和开心果检测。在 FA 组中，72.7%和 56.8%分别患有 AD 和多种 FA。AD 亚组的多种 FA（56.8%比 49.8%，p < 0.005）和鸡蛋过敏（85.5%比 50.2%，p < 0.005）更常见，而牛奶过敏（51.4%比 67.1%，p < 0.005）则较少见。FA 组中 AD 亚组的多种 FA 可能性随着 AD 的严重程度平行增加（p < 0.05）。在 AD 组中，58.2%存在 IgE 介导的 FA。AD 症状起始年龄越小（OR 0.800[95%CI 0.731-0.875]；p < 0.001），AD 严重程度越高（OR 2.350[95%CI 1.898-2.911]；p < 0.001），伴随 FA 的风险就越高。
尽管严重和早发 AD 是婴儿期 FA 存在和严重程度的预测因素，但 FA 谱是文化特征的反映。AD 和 FA 的临床表现实际上可能是特应性和过敏症下免疫失调程度的表现。
