Clinical phenotypes of childhood food allergies based on immune mechanisms: A multicenter study

Handan DUMAN ŞENOL; Ayşen Bingöl; Dilara Fatma Kocacık Uygun; Meltem Akdemir; Kamil Hakan Erengin

doi:10.2500/aap.2021.42.210005

Clinical phenotypes of childhood food allergies based on immune mechanisms: A multicenter study

Makaleler > Tam Makale · 2021

Yazarlar: Handan DUMAN ŞENOL, Ayşen Bingöl, Dilara Fatma Kocacık Uygun, Meltem Akdemir, Kamil Hakan Erengin

ALLERGY AND ASTHMA PROCEEDINGS, SCI Expanded İndekslerine Giren Dergi, Uluslararası, 2021, cilt 42, ss 86-95

DOI: 10.2500/aap.2021.42.210005

Özet

ABSTRACTBackground: Food allergies (FA) are an important public health concern that place a major burden on the lives of children andtheir families. The complex pathogenesis of FAs results in multisystemic and heterogenous clinical presentations.Objective: To evaluate, according to immune mechanisms, the characteristics and risk factors of childhood FA in Turkey.Methods: This descriptive multicenter study included 1248 children with FA, aged < 18 years,, who were evaluated by pe-diatric allergists in 26 different centers.Results: Immune mechanisms of FA were immunoglobulin E (IgE) mediated in 71.8%, non–IgE mediated in 15.5%,and mixed IgE/non–IgE mediated in 12.7% of the patients. An episode of anaphylaxis had occurred in 17.6% of IgE-medi-ated FA. The most common food allergens were classi?ed into ?ve categories (in order of decreasing frequency): cow’smilk, egg, tree nuts and/or peanut, wheat, and seafood. Allergies to cow’s milk and egg declined signi?cantly with age,whereas tree nuts and/or peanut allergies increased with age. The 0–2 year age group accounted for 62.5% of the cases.The most frequent cause of FA and food anaphylaxis was cow’s milk before age 13 years and tree nuts and/or peanut dur-ing adolescence (ages 13–18 years). Compared with other phenotypes, male sex (odds ratio [OR] 1.486; p = 0.032), sibling(s) (OR 1.581; p = 0.021), and maternal atopy (OR 1.531; p = 0.045) increased the likelihood of IgE-mediated FA, whereashigh household income (OR 1.862; p = 0.026) increased the likelihood of non–IgE-mediated FA in multivariate regressionanalysis.Conclusion: This study showed that the clinical ?ndings of FA were highly variable, depending on age and underlyingimmune mechanism. Knowing the population characteristics will enable better management of FA in children.

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