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


Aydoğan M., Topal E., Uysal P., Acar H. C., Cavkaytar O., Hızlı Demirkale Z., ...More

INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY, vol.182, no.7, pp.607-614, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 182 Issue: 7
  • Publication Date: 2021
  • Doi Number: 10.1159/000513267
  • Journal Name: INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, Food Science & Technology Abstracts, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.607-614
  • Keywords: Childhood, Food allergy, Urticaria, ALLERGY, IGE, ANAPHYLAXIS, CHALLENGE, EPIDEMIOLOGY, PROGRESSION, GUIDELINES, MANAGEMENT, CHILDREN
  • Istanbul University Affiliated: Yes

Abstract

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.