Proven Food-Induced Acute Urticaria and Predictive Factors for Definitive Diagnosis in Childhood

2021 ◽  
pp. 1-8
Author(s):  
Metin Aydoğan ◽  
Erdem Topal ◽  
Pınar Uysal ◽  
Hazal Cansu Acar ◽  
Ozlem Cavkaytar ◽  
...  
Keyword(s):  
Food Allergy ◽  
Food Challenge ◽  
Signs And Symptoms ◽  
Definitive Diagnosis ◽  
Cow’S Milk ◽  
Cross Sectional ◽  
Acute Urticaria ◽  
Cow's Milk ◽  
Study Results ◽  
History Of

Background: Urticaria can be the only sign of a food allergy or can be seen together with other signs and symptoms of a food allergy. Objective: To determine the demographic, etiologic, and clinical features of food-induced acute urticaria in childhood. Methods: Patients suspected of food-induced acute urticaria were included in this prospective cross-sectional multicenter study. Results: Two hundred twenty-nine urticaria cases were included in this study. Seventeen patients who did not meet the inclusion criteria of the study were excluded. Of the 212 included cases, 179 (84.4%) were diagnosed with definitive food-induced acute urticaria. The most common foods causing acute urticaria were cow’s milk, hen’s eggs, and nuts in 56.4, 35.2, and 19% of cases, respectively. The positive predictive value of a history of milk-induced acute urticaria together with a milk-specific IgE >5 kU/L for cow’s milk-induced acute urticaria was 92% (95% CI: 81–96%). A history of cow’s milk-induced and/or hen’s egg-induced acute urticaria was consistent with a definitive diagnosis of food-induced urticaria (Chen’s kappa: 0.664 and 0.627 for milk and eggs, respectively). Urticaria activity scores were higher in patients with food-induced acute urticaria (p = 0.002). Conclusion: Cow’s milk, hen’s eggs, and nuts were the most common allergens in the etiology of childhood food-induced acute urticaria. Although the urticaria activity score provides guidance for diagnosis, an oral food challenge is often essential for the definitive diagnosis of a patient with a history of food-induced acute urticaria.

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

2021 ◽  
Vol 49 (3) ◽  
pp. 185-192
Author(s):  
Hilal Unsal ◽  
Gokce Ozyilmaz Bozat ◽  
Melike Ocak ◽  
Aysegul Akarsu ◽  
Umit Murat Sahiner ◽  
...  
Keyword(s):  
Food Allergy ◽  
Preschool Children ◽  
Food Challenge ◽  
Oral Food Challenge ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Tree Nuts ◽  
Increased Risk ◽  
Hen’S Egg ◽  
Ige Mediated

Background: The oral food challenge (OFC) in IgE mediated food allergy causes anxiety both in parents and in patients due to its inherent risks.Objective: Documentation of the rate, spectrum, and predictors of positive reactions is instructive.Methods: Children, who underwent OFC between January 1, 2017 and December 31, 2019 were analyzed.Results: 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 consid-ered 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.Conclusion: 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.

Prevalence of Food Allergy among Schoolchildren in Lebanon

2022 ◽  
pp. 1-6
Author(s):  
Jana Sakakini ◽  
Carla Irani ◽  
Rana Bikai ◽  
Gretta Sahyoun ◽  
Souheil Hallit ◽  
...  
Keyword(s):  
Food Allergy ◽  
Mode Of Delivery ◽  
Clinical Manifestations ◽  
Developed Countries ◽  
Cow’S Milk ◽  
Delivery Mode ◽  
Cross Sectional ◽  
Skin Reactions ◽  
Cow's Milk ◽  
Gi Symptoms

<b><i>Introduction:</i></b> Food allergy (FA) is a global health problem with an ongoing rise in prevalence, especially in developed countries. It has been reported to be most prevalent in children, although cases in adults have been increasing as well. FA may lead to life-threatening clinical manifestations. Data in Lebanon and the Middle East are limited. To our knowledge, few studies tackled its prevalence in children in this region. <b><i>Aim:</i></b> This study aims at determining self-reported prevalence of FA in schoolchildren (ages 3–17 years) in Lebanon and describes its characteristics. <b><i>Method:</i></b> Throughout this cross-sectional study, 5 schools from 3 different governorates in Lebanon (Beirut, Mt. Lebanon, and Beqaa) were contacted to participate and 5,312 questionnaires were sent out to be completed by the parents and sent back to the school during May 2019. <b><i>Results:</i></b> 2,610 questionnaires were collected (49.13%). A hundred and forty-eight (6%) children reported to have FA, 58% were males. 80% of them were breastfed, 51% were diagnosed between the ages of 2 and 14 years. Common allergens included cow’s milk and milk products (22.46%), fruits and vegetables (16.58%), eggs (8.02%), and nuts (5.88%). Allergic symptoms included skin reactions (45.08%), gastrointestinal (GI) symptoms (29.53%), respiratory symptoms (14.51%), and systemic symptoms (10.88%). 82% of the population with FA has sought professional advice, out of which 54% were confirmed by a physician. Common methods of diagnosis were IgE test (35.71%), food elimination (27.92%), and skin prick test (18.83%). χ<sup>2</sup> analysis has shown that a higher percentage of children with FA had skin reactions (58.8%, <i>p</i> = 0.033) and GI symptoms (30.41%, <i>p</i> = 0.047). A higher percentage of children with allergies were breastfed. No relation between the presence of FA and delivery mode was observed. <b><i>Conclusion:</i></b> This study has shown that the self-reported prevalence of FA among Lebanese schoolchildren is 6%, and it was correlated with skin and GI symptoms. The most common allergen was cow’s milk. A higher proportion of children with FA were breastfed. No association between the mode of delivery and FA was found. Larger studies are needed to confirm the above findings.

Baked Tolerance in Cow’s Milk Allergy: Quite Frequent, Hard to Predict!

2020 ◽  
pp. 1-5
Author(s):  
Lisis Karine Vilar ◽  
Flávia Alves Araújo ◽  
Thalita Pereira Santos ◽  
Thatiana Tavares Menezes ◽  
Marina F. Cheik ◽  
...  
Keyword(s):  
Food Challenge ◽  
Specific Ige ◽  
Cross Sectional Study ◽  
Cow’S Milk ◽  
Cross Sectional ◽  
Prick Test ◽  
Cow's Milk ◽  
Baked Goods ◽  
Baked Foods ◽  
Baked Milk

<b><i>Introduction:</i></b> Cow’s milk protein allergy (CMA) is the most common type of food allergy in childhood and exclusion diet is a challenge for patients. <b><i>Objective:</i></b> The study aim was to investigate the frequency of tolerance to baked foods containing milk and evaluate immediate skin prick test (SPT) and specific IgEs for different cow’s milk (CM) protein types as predictors of tolerance to baked foods containing milk for CMA patients. <b><i>Methods:</i></b> A cross-sectional study was performed. Fifty-four CMA patients were enrolled and oral food challenge (OFC) was performed with baked product, 6 different milk SPTs and specific IgEs to CM, casein, α-lactalbumin, and β-lactoglobulin. <b><i>Results:</i></b> Thirty-nine (72.2%) patients tolerated OFC with baked milk cupcake. CM-specific IgE and casein SPT showed statistical difference between positive and negative OFC groups. Probability curves for baked milk tolerance were created for specific CM IgE (<i>Z</i> = 2.542, <i>p</i> &#x3c; 0.0110) and casein SPT (<i>Z</i> = 2.290, <i>p</i> &#x3c; 0.0220) using logistic regression. <b><i>Conclusions:</i></b> The high percentage of patients able to tolerate baked goods enables an improvement in intake possibilities and quality of life of CMA patients and families. Specific CM IgE and casein SPT demonstrated to be useful predictors in relation to baked milk tolerance.

scholarly journals COVID-19 Vaccines in Children with Cow’s Milk and Food Allergies

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2637
Author(s):  
Lucia Liotti ◽  
Annamaria Bianchi ◽  
Paolo Bottau ◽  
Silvia Caimmi ◽  
Giuseppe Crisafulli ◽  
...  
Keyword(s):  
Food Allergy ◽  
Current Data ◽  
Food Allergies ◽  
Cow’S Milk ◽  
Allergic Reactions ◽  
Health Crisis ◽  
Cow's Milk ◽  
Post Marketing ◽  
History Of ◽  
Observation Period

The COVID-19 pandemic is the most challenging global health crisis of our times. Vaccination against COVID-19 plays a key role to control the current pandemic situation. The risk of allergic reactions to new COVID-19 vaccines is low. However, there is a debate on the safety in allergic patients following post marketing findings by different agencies. Our aim is to understand from current experiences whether children with cow’s milk or food allergy are at higher risk than a general population for allergic reactions to COVID-19 vaccines. Current data indicate that patients with a history of allergy to cow’s milk or other foods, even if severe, should receive COVID-19 vaccine in a setting with availability of treatments for anaphylactic reactions and under medical supervision. Recipients should be discharged after a protracted observation period of 30 min if no reaction developed.

scholarly journals Cow’s milk exposure and atopic dermatitis after six months of age

2017 ◽  
Vol 56 (6) ◽  
pp. 325
Author(s):  
Surya Jayanti Kadek ◽  
Dewi Kumara Wati Ketut ◽  
Karyana Putu Gede
Keyword(s):  
Atopic Dermatitis ◽  
Maternal Diet ◽  
Multiple Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Cow’S Milk ◽  
Milk Formula ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cow's Milk ◽  
Study Population

Background About 60% of individuals with atopic dermatitis (AD) develop their first manifestation during infancy. Cow’s milk (CM) exposure is considered to be a risk factor for AD.Objective To evaluate for an association between cow’s milk exposure and atopic dermatitis in infants > 6 months of age.  Methods This cross-sectional study consisted of subjects from a previous study and new subjects recruited in order to meet the minimum required number of subjects. Our study population comprised 120 infants, born between 1 February and 30 November, 2012 in Sanglah Hospital, Denpasar. Subjects were divided into CM and non-CM groups and analyzed for their risk of AD. Subjects were included to CM group if they were fed with cow’s milk/formula  and included to non-CM group if they were breastfeed exclusively in the first six months of life. Other possible risk factors were assessed by multivariate analysis. Results One hundred twenty subjects were enrolled and analyzed (59 in the CM and 61 in the non-CM groups). The prevalence of AD was 30%. Multiple logistic regression analysis revealed a significant association between CM exposure and AD, with odds ratio (OR) 2.37 (95%CI 1.036 to 5.420; P=0.04). In addition, maternal diet including eggs and/or cow’s milk during the breastfeeding period was significantly associated with AD in infants (OR 3.18; 95%CI 1.073 to 9.427; P=0.04).Conclusion Cow’s milk exposure is significantly associated with atopic dermatitis in infants  > six months of age. 

Alteration of Allergen Fold of Bos d 5 into a Hypoallergenic Vaccine for Immunotherapy of Cow’s Milk Allergy

2021 ◽  
pp. 1-12
Author(s):  
Yaqiong Cui ◽  
Yang Yu ◽  
Shuxiang Lin ◽  
Li Xu ◽  
Liuxu Li ◽  
...  
Keyword(s):  
Food Allergy ◽  
T Cell ◽  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Milk Allergy ◽  
T Cell Epitopes ◽  
Dot Blot ◽  
Allergen Specific Immunotherapy ◽  
Cow's Milk ◽  
Cow's Milk Allergy

<b><i>Background:</i></b> Cow’s milk allergy (CMA) is the most common IgE-mediated food allergy and Bos d 5 is the major allergen in cow’s milk proteins. More than 60% of the patients with CMA are sensitized to this protein. <b><i>Methods and Results:</i></b> A recombinant protein, encoded by a synthetic gene and consisting of reassembled Bos d 5 fragments, was expressed in <i>E. coli</i> strain BL21 (DE3) cells and purified to homogeneity. The B5M lacked relevant IgE-reactivity and allergenic activity compared with Bos d 5 in dot-blot and basophil activation assays. T-cell proliferation experiments demonstrated that B5M preserved the main T cell epitopes of Bos d 5. Immunization of rabbits with B5M induced protective IgG antibodies that blocked the binding of patients’ IgE antibodies to the wild-type allergen and inhibited the degranulation of basophils induced by Bos d 5. <b><i>Conclusion:</i></b> Thus, we developed a new strategy, which was based on rational molecular reassembly for allergen-specific immunotherapy (AIT) of CMA and food allergy.

scholarly journals Prévalence De La Douleur Neuropathique Chez Des Patients Souffrant De Lomboradiculalgie Commune En Consultation Rhumatologique À Lomé (Togo)

2017 ◽  
Vol 13 (24) ◽  
pp. 267
Author(s):  
Kodjo Kakpovi ◽  
Komi Cyrille Tagbor ◽  
Eyram Fianyo ◽  
Agbeko Komlan Doleagbenou ◽  
Kokou Mensah Guinhouya ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Past History ◽  
Cross Sectional Study ◽  
Radicular Pain ◽  
Low Back ◽  
Cross Sectional ◽  
Study Results ◽  
History Of

Objective: To determine the prevalence and factors associated with neuropathic pain in patients with non-specific low back pain. Methods: This was a cross-sectional study conducted from May to July 2016 in the Rheumatology, Neurology and Neurosurgery departments of Lome. The DN4 questionnaire was used for the diagnosis of neuropathic pain in the 200 patients with low back pain included in this study. Results: Of the 200 patients (147 women and 53 men) included in the study, neuropathic pain was present in 92 (46%). The average age of the 92 patients (67 women vs 25 men, p = 0.04) was 55.5 ± 12.4 years (women 55.2 ± 12.8 vs. men 54.6 ± 11.4, p = 0.5). The characteristics of neuropathic pain mainly found were: burning sensation (n = 67, 72.8%); electrical discharges (n = 64, 69.6%); tingling (n = 90; 97.8%); tickling (n = 57; 62%); numbness (n = 89; 96.7%); hypoesthesia (n = 52; 56.5%). Factors significantly associated with the presence of neuropathic pain in LBP were age (p = 0.005), duration of LBP (p = 0.04), high blood pressure (p = 0.001), radicular pain (p = 0.00002) and the past history of the LBP (0.000000). Conclusion: Neuropathic pain is common in patients with LBP at Lome. The duration of LBP, past history of LBP, previous NSAID use, BMI, pain severity and radicular pain appear to be predictive of the occurrence of these neuropathic pains.

scholarly journals PREVALENCE OF HYPERTENSION IN ADULT POPULATION OF HAYATABAD PESHAWAR

1969 ◽  
Vol 5 (1) ◽  
pp. 644-647
Author(s):  
SARA GUL ◽  
ATIF HUSSAIN ◽  
KASHIF UR REHMAN KHALIL ◽  
IMRANULLAH ◽  
MUHAMMAD ISHTIAQ ◽  
...  
Keyword(s):  
Communicable Disease ◽  
Adult Population ◽  
Positive Association ◽  
Developed Countries ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Study Results ◽  
History Of ◽  
Study Population

BACKGROUND: Hypertension is one of the common non communicable disease and is reported to beprevalent in 20% to 50% of the adult population, hypertension is one of the major contributor ofmortality and morbidity in developing and developed countries. The cross-sectional descriptive studywas formulated to find the prevalence and to assess different etiological factors of hypertension.MATERIAL & METHODS: This cross-sectional study among 400 adults of age 25-75 years wasconducted in months of June to December 2014 in Phase 5, Hayatabad Peshawar. A detailed structuredproforma having important questions was used to collect important data regarding various variables.RESULTS: Our study results showed that 22.75% of the study people were hypertensive i.e. 10.25% ofmales and 12.5% of females; and the prevalence of hypertension showed positive association withadvancing age. Out of all respondents; 60.25% were males while 39.75% were females; 28.5% weresmokers; 5.25% consume predominantly meat; 32.5% were obese & overweight; 36.75% checked theirB.P regularly; and 19.75% had positive history of hypertension in family.CONCLUSION: We conclude that hypertension prevalence was high among our study population andwas associated with various modifiable and non modifiable risk factors thus population based preventivestrategies are needed to control and prevent hypertension.KEY WORDS: Hypertension, Age, Diet, Smokers, Hayatabad, Peshawar.

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