Çocukluk Çağı Besin Alerjilerinin Klinik Fenotiplendirmesi

Abstract

Koken, G. Food allergy phenotypes in childhood. Hacettepe University Faculty of Medicine, Thesis in Pediatrics. Ankara, 2019. Food allergy is defined as adverse food reactions that occur through immune-mediated mechanisms. These immune mechanisms may be IgE-mediated, cell-mediated (non-IgE) and both IgE-mediated and cell-mediated (mixed). It is an important public health problem that can result in life-threatening reactions and its frequency is increasing. The aim of this study was to evaluate the clinical phenotyping of food allergies in childhood by analyzing the demographic characteristics, clinical presentation patterns, accompanying atopy status, family history and diagnostic tests and to compare the single versus multiple food allergies in children followed up at Hacettepe University Pediatric Allergy Outpatient Clinic. In our study, 537 patients admitted to our outpatient clinic between July 2017 and July 2019 were evaluated retrospectively and prospectively. The study group includes who were previously followed food allergy diagnosis, currently being followed up with food allergy diagnosis and newly diagnosed food allergy. Four hundred twenty-two patients (%78.6) had IgE-mediated food allergy, 57 patients (%10.6) had non-IgE-mediated food allergy and 58 patients (%10.8) had non-IgE-mediated and IgE-mediated food allergy. In patients with IgE-mediated food allergy the most common responsible allergen was egg white (%81.5), the most common symptom was eczema (%82); in patients with non-IgE mediated food allergy the most common responsible allergen was cow’s milk (%94.7), the most common symptom was bloody stool (%82.5); in patients with non-IgE mediated and IgE-mediated food allergy the most common responsible allergen was cow’s milk (%96.6), the most common symptom was bloody stool (%84.5). In children with egg allergy urticaria, angioedema, dyspnea and wheezing were more common in patients followed up with multiple food allergies compared to isolated egg allergic children (p=0.004, p<0.001, p=0.035, p=0.025, respectively). Also anaphylaxis was shown to be common (p=0.004), eosinophil percentage and total serum IgE values were higher (p=0.017, p<0.001) in children with egg allergy having multiple food allergies. In children with cow’s milk allergy, symptoms appeared earlier (p=0.025); eczema and house dust sensitivity was more frequent (p<0.001, p=0.019) in patients with multiple food allergies than those with isolated cow's milk allergy. In addition, absolute eosinophil count, eosinophil percentage and total serum IgE values were higher (p=0.029, p=0.018, p<0.001, respectively) in these patients. Accurately identifying food allergies in the light of similar studies will contribute to the reduction of mortality and morbidity by ensuring the correct management of patients diagnosis, treatment and follow-up processes.