Cogurlu Mujde Tuba, Aydogan Metin, Cavkaytar Ozlem, Uysal Pinar, Culpan Hazal Cansu, Yakici Nalan, Demirkale Zeynep Hizli, Topal Erdem, Yuksel Hasan, Aydemir Sezin, Cigerci Gunaydin Nursen, Aydogmus Cigdem, Cekic Sukru, Akkelle Emre, Tuncel Tuba, Eser Simsek Isil, Arga Mustafa, Altinel Zeynep Ülker, Kaplan Fatih, Kiykim Ayca, Suleyman Ayse, Guler Nermin, Yucel Esra, Cokugras Haluk, Sapan Nihat, Nacaroglu Hikmet Tekin, Yasar Adem, Yesil Yakup, Hancioglu Gonca, Sancak Recep, Erdogan Mehmet Sarper, Ozdemir Oner, Ozdemir Cevdet, Orhan Fazil
Department of Pediatric Allergy and Immunology, Sakarya Training and Research Hospital, 54100 Sakarya, Türkiye.
Department of Pediatric Allergy and Immunology, Faculty of Medicine, Kocaeli University, 41000 Kocaeli, Türkiye.
Diagnostics (Basel). 2025 Oct 21;15(20):2656. doi: 10.3390/diagnostics15202656.
Atopic dermatitis (AD) and food allergy (FA) are common allergic diseases in early childhood. AD may be concomitant with FA, particularly in young children. Although studies report the prevalence of FA in children with AD, there is insufficient data regarding different phenotypes of FA. The aim of our research was to determine the prevalence and clinical predictors of different phenotypes of concomitant FA in children with AD. This cross-sectional multicenter study included patients younger than 24 months old diagnosed with AD, recruited from 14 pediatric allergy centers. Patients were categorized into two groups using skin testing, allergen-specific IgE, and ultimately food challenge testing (FCT): those with FA and those without. Individuals with FA were classified into three distinct phenotypes: IgE-mediated, non-IgE-mediated, and concurrent IgE- and non-IgE-mediated. The data of 530 children [59% male, median-age 7 months (IQR: 5-11)] were analyzed. IgE-mediated FA was found in 28.1% of participants, whereas 22.4% ( = 119/530) exhibited non-IgE-mediated FA. Concurrent IgE- and non-IgE-mediated FA was reported in 12.1% ( = 64/530) of patients. Cow's milk (69.6%) and egg-white (68.9%) were identified as the most prevalent allergens. Cow's milk was primarily responsible for non-IgE-mediated and egg-white for IgE-mediated FA. The most significant predictors of FA were severe AD and the presence of blood in stool with odds ratios of 8.25 (95% Cl: 3.04-22.39) and 10.04 (95% CI: 2.03-49.59), respectively ( < 0.01) ( < 0.005). The study's findings indicate that children with early-onset and mild-to-moderate AD deserve to be comprehensively assessed for FA symptoms. The most significant indicators of concomitant FA in AD patients were the presence of blood in stool and severe AD. It is important to consider that those who exhibit IgE-mediated FA may also have concurrent non-IgE-mediated FA. We underline that it is important to consider that children with AD who exhibit IgE-mediated FA may also have concurrent non-IgE-mediated FA. Addressing these symptoms may assist healthcare practitioners in clinical practice to improve the quality of care for AD patients having FA.
特应性皮炎（AD）和食物过敏（FA）是幼儿期常见的过敏性疾病。AD可能与FA并存，尤其是在幼儿中。尽管有研究报告了AD患儿中FA的患病率，但关于FA不同表型的数据不足。我们研究的目的是确定AD患儿中并存FA不同表型的患病率及临床预测因素。这项横断面多中心研究纳入了从14个儿科过敏中心招募的24个月以下诊断为AD的患者。通过皮肤试验、过敏原特异性IgE检测以及最终的食物激发试验（FCT）将患者分为两组：有FA组和无FA组。有FA的个体被分为三种不同表型：IgE介导型、非IgE介导型以及IgE和非IgE同时介导型。分析了530名儿童的数据[男性占59%，中位年龄7个月（四分位间距：5 - 11个月）]。28.1%的参与者存在IgE介导的FA，而22.4%（n = 119/530）表现为非IgE介导的FA。12.1%（n = 64/530）的患者报告存在IgE和非IgE同时介导的FA。牛奶（69.6%）和蛋清（68.9%）被确定为最常见的过敏原。牛奶主要导致非IgE介导的FA，蛋清则导致IgE介导的FA。FA最显著的预测因素是重度AD和大便带血，优势比分别为8.25（95%置信区间：3.04 - 22.39）和10.04（95%置信区间：2.03 - 49.59）（P < 0.01）（P < 0.005）。研究结果表明，早发型轻至中度AD患儿值得全面评估FA症状。AD患者并存FA最显著的指标是大便带血和重度AD。需要考虑的是，表现为IgE介导的FA的患者可能同时存在非IgE介导的FA。我们强调，对于表现为IgE介导的FA的AD患儿可能同时存在非IgE介导的FA这一点很重要。解决这些症状可能有助于临床医生在临床实践中提高对患有FA的AD患者的护理质量。
