Date Published: June 18, 2018
Publisher: BioMed Central
Author(s): Victoria Alejandra Gonzales-González, Adolfo Martin Díaz, Karla Fernández, María Félix Rivera.
Food allergy is a public health problem that has increased in the last decade. Despite the increasing rates in children, quality data on the burden of these diseases is lacking particularly in developing countries. Honduras has no studies in pediatric patients.
The objective of this research was to identify the most common sensitization patterns to food through epicutaneous skin testing and food allergy rates in children and their correlation with common allergic diseases in a group of patients from Hospital of Pediatrics Maria.
Cross-sectional retrospective, descriptive study in which records and database of all allergic patients in the immunology outpatient clinic from Hospital of Pediatrics Maria were reviewed between the periods of January 2015 through June 2016.
A total of 365 children were analyzed, the age of participants were in the range from 1 to 18 years, with an average of 9.8 years. Sensitization to food allergens were found in 23, and 58.3% were poly-sensitized. The most common food allergens that patients were sensitized to: milk 9.0%, eggs 6.9%, peanut 4.9% and pork meat 4.4%. Food allergy was confirmed via oral food challenged in 9.3% of the patients. The most frequent food allergies found were: cow’s milk allergy 6%, hen’s egg allergy 5.2% and wheat allergy 1.9%.
Milk and egg were the most common a food allergens found in the population studied. Most of the patients were found to be poly-sensitized. The frequent food allergies confirmed via oral food challenge were cow’s milk allergy, hen’s egg allergy and wheat allergy.
Sensitization, or the presence of allergic antibody, is a pre-requisite for development of an allergic response to an allergen. Patterns of sensitization to environmental and food allergens have previously been studied in children in an effort to better understand allergy development [1, 2]. A reaction to a food allergen can cause a wide range of clinical responses, ranging from urticaria to anaphylaxis, the most severe form of allergic reaction . The current standard of care is based on identification and strict avoidance of triggering foods [4, 5]. If criteria for anaphylaxis are met, prompt administration of epinephrine is required .
Cross-sectional retrospective study in which records and database of all allergic patients in the immunology outpatient clinic from Hospital of Pediatrics Maria were reviewed between the periods of January 2015 through June 2016. 365 files were reviewed. The diagnosis of allergic diseases was established according to the GINA guidelines for asthma, ARIA for rhinitis, Hanif and Rajka for diagnoses and SCORAD for assessing the severity of atopic dermatitis . Urticaria and conjunctivitis were also included. Patients meeting the criteria of two or more allergic diseases were considered as multisystemic.
A total of 365 children were analyzed in this study, ranging in age from 1 to 18 years old with an average of 9.8 years. Skin prick testing with food extracts gave a positive result in 84 children to at least one food allergen (23%). The demographic characteristics are shown in Table 1.Table 1Characteristics Clinical epidemiological of the children in the immunology outpatient clinicVariableSensitization to food allergenYes, n = 84N (%)No, n = 281N (%)Gender Female48 (57.1)122 (43.4) Male36 (42.9)159 (56.6)Pediatric stage Toddler (1–3 years)9 (10.7)13 (4.6) Pre-school (4–6 years)14 (16.7)55 (19.6) Childhood (7–11 years)33 (39.3)101 (35.9) Early adolescence (12–14 years)13 (15.5)58 (20.6) Late adolescence (15–18 years)15 (17.9)54 (19.2)Diagnosis Multisystemic61 (72.6)199 (70.8) Allergic rhinitis11 (13.1)38 (13.5) Atopic dermatitis5 (5.6)14 (5.7) Asthma3 (3.6)12 (4.3) Urticaria4 (4.8)6 (2.1) Atopic conjunctivitis0 (0)6 (2.1)Food allergy34 (9.3)331 (90.7%)Procedence Francisco Morazán76 (88.6)249 (90.5) El Paraíso4 (4.8)7 (2.5) Intibucá0 (0)10 (3.7) Choluteca0 (0)4 (1.4) Olancho1 (1.2)3 (1.1) Comayagua1 (1.2)2 (0.7) Atlántida1 (1.2)1 (0.4) La Paz1 (1.2)1 (0.4) Copan0 (0)1 (0.4) Cortes0 (0)1 (0.4) Santa Barbara0 (0)1 (0.4) Valle0 (0)1 (0.4)
This study determined the prevalence of food sensitization through SPT among 365 children with allergic diseases. The age of participants were in the range from 1 to 18 years, with an average of 9.8 years. The individual prevalence of food allergen sensitization type was different in our study, which may be due to cultural differences in food habits, although we cannot exclude the possibility that the lower size of our sample in comparison with other studies might have influenced the results. In spite of the fact we performed open food challenges in some of the patients, it was not possible to perform double blind placebo-controlled food challenges, which are regarded as the “gold standard” for the final diagnosis of food allergies. This was a weakness of our methodology.