Oral food challenge in IgE mediated food allergy in eastern Mediterranean children

The oral food challenge (OFC) in IgE mediated food allergy causes anxiety both in parents and in patients due to its inherent risks. Documentation of the rate, spectrum, and predictors of positive reactions is instructive. Children, who underwent OFC between January 1, 2017 and December 31, 2019 wer...

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Bibliographic Details
Published in:	Allergologia et immunopathologia Vol. 49; no. 3; p. 185
Main Authors:	Ünsal, Hilal, Bozat G, Gökçe Özyılmaz, Ocak, Melike, Akarsu, Ayşegül, Şahiner, Ümit Murat, Soyer, Özge, Şekerel, Bülent Enis
Format:	Journal Article
Language:	English
Published:	Singapore 01-01-2021
Subjects:	Anaphylaxis - etiology Anaphylaxis - immunology Asthma - complications Asthma - immunology Child, Preschool Confidence Intervals Egg Hypersensitivity - diagnosis Egg Hypersensitivity - immunology Epinephrine - therapeutic use Female Food Hypersensitivity - diagnosis Food Hypersensitivity - immunology Humans Immunoglobulin E - immunology Male Milk Hypersensitivity - diagnosis Milk Hypersensitivity - immunology Nut Hypersensitivity - diagnosis Nut Hypersensitivity - immunology Odds Ratio Seeds - immunology Sesamum - immunology Severity of Illness Index Time Factors Wheat Hypersensitivity - diagnosis Wheat Hypersensitivity - immunology positive reaction anaphylaxis children food allergy oral food challenge IgE
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Summary:	The oral food challenge (OFC) in IgE mediated food allergy causes anxiety both in parents and in patients due to its inherent risks. Documentation of the rate, spectrum, and predictors of positive reactions is instructive. Children, who underwent OFC between January 1, 2017 and December 31, 2019 were analyzed. A total of 1361 OFCs in 613 cases were reviewed. Most of them were performed in preschool children (≤2 years 50%) and 55% of them had more than one OFC. Mainly considered food groups were cow's milk (31.8%), hen's egg (28.5%), tree nuts (20%), legumes (7%), seeds (4.9%), and wheat (2.7%). The overall OFC positivity was 9.6%, whereas 6.7% with cow's milk, 4.9% with hen's egg, 16.1% with tree nuts, 21.6% with wheat, and 32.8% with seeds. The severity scoring revealed grade I (24.4%), II (45.8%), and III (29.7%) reactions. Fifty (38%) cases required epinephrine and four cases required hospitalization. OFCs with sesame seeds (odds ratio [OR]: 7.747, [confidence interval (CI) 95%: 4.03-14.90]), wheat (OR: 3.80, [CI: 1.64-8.84]), and tree nuts (OR: 2.78, [CI: 1.83-4.23]) predicted a positive OFC while a concomitant asthma (OR: 3.61 [CI: 1.27-10.28]) was more likely to elicit anaphylaxis. In OFC practice, priority is given to basic nutritional sources and the most frequent food allergens, where preschool children with multiple sensitizations are the primary subjects. Increased risks of positive reactions with sesame, tree nut, and wheat and increased risk of anaphylaxis with concomitant asthma should be considered while performing OFC.
ISSN:	1578-1267
DOI:	10.15586/aei.v49i3.189