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J Allergy Clin Immunol Pract. 2014 Mar-Apr;2(2):168-71. doi: 10.1016/j.jaip.2013.10.002. Epub 2013 Dec 8.

Prevalence of sensitivity to food and drug additives in patients with chronic idiopathic urticaria.

Author information

  • 1Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, Calif. Electronic address: rajan.jessica@scrippshealth.org.
  • 2Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, Calif.
  • 3Allergy & Asthma Consultants of Rockland and Bergen, West Nyack, NY.

Abstract

BACKGROUND:

Chronic idiopathic urticaria (CIU) is defined as the presence of urticaria most days of the week for a period of 6 weeks or longer. There have been reports of food additive sensitivity in CIU previously, but the prevalence has not been precisely determined.

OBJECTIVE:

To determine the prevalence of reactions to food and drug additives in patients with CIU.

METHODS:

We challenged 100 patients in our allergy/immunology division with CIU to the 11 additives most commonly associated with reactions: tartrazine (FD&C Yellow 5), potassium metabisulfite, monosodium glutamate, aspartame, sodium benzoate, methyl paraben, butylated hydroxy anisole, butylated hydroxy toluene, FD&C Yellow 6, sodium nitrate, sodium nitrite. All of the patients had a history of CIU for longer than 6 weeks, and 43 reported possible history of food or drug additive sensitivity. Single-blind challenges to all of the additives were performed in the clinic and skin scores were recorded. Subjects with positive challenge tests underwent double-blind placebo controlled challenges.

RESULTS:

Of 100 subjects, only 2 had a positive urticarial response on single-blind challenge. Neither of these patients had a positive urticarial response on double-blind placebo-controlled challenge. There were no gastrointestinal, respiratory, or other symptom, and no patients reported late reactions.

CONCLUSION:

We were able to conclude, with 95% confidence intervals that sensitivity to any of the 11 food and drug additives occurs in fewer than 1% of patients with CIU. Food and drug additives appear to be a rare cause of CIU, and avoidance is not recommended.

KEYWORDS:

Chronic idiopathic urticaria; Drug additives; Food additives

PMID:
24607044
DOI:
10.1016/j.jaip.2013.10.002
[PubMed - indexed for MEDLINE]
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