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J Allergy Clin Immunol Pract. 2017 Sep - Oct;5(5):1325-1334.e4. doi: 10.1016/j.jaip.2017.01.016. Epub 2017 Mar 27.

Association of Clinical Reactivity with Sensitization to Allergen Components in Multifood-Allergic Children.

Author information

1
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, Calif; Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, Calif.
2
Thermo Fisher Scientific, Immunodiagnostics, Uppsala, Sweden; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
3
Division of General Medicine, Department of Medicine, Stanford University, Stanford, Calif.
4
Thermo Fisher Scientific, Immunodiagnostics, Uppsala, Sweden.
5
Thermo Fisher Scientific, Immunodiagnostics, Kalamazoo, Mich.
6
Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, Calif; Departments of Pathology and of Microbiology and Immunology, Stanford University School of Medicine, Stanford, Calif.
7
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, Calif; Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, Calif. Electronic address: knadeau@stanford.edu.

Abstract

BACKGROUND:

Thirty percent of children with food allergies have multiple simultaneous allergies; however, the features of these multiple allergies are not well characterized serologically or clinically.

OBJECTIVE:

We comprehensively evaluated 60 multifood-allergic patients by measuring serum IgE to key allergen components, evaluating clinical histories and medication use, performing skin tests, and conducting double-blind, placebo-controlled food challenges (DBPCFCs).

METHODS:

Sixty participants with multiple food allergies were characterized by clinical history, DBPCFCs, total IgE, specific IgE, and component-resolved diagnostics (IgE and IgG4) data. The food allergens tested were almond, egg, milk, sesame, peanut, pecan, walnut, hazelnut, cashew, pistachio, soy, and wheat.

RESULTS:

Our data demonstrate that of the reactions observed during a graded DBPCFC, gastrointestinal reactions occurred more often in boys than in girls, as well as in individuals with high levels of IgE to 2S albumins from cashew, walnut, and hazelnut. Certain food allergies often occurred concomitantly in individuals (ie, cashew/pistachio and walnut/pecan/hazelnut). IgE testing to components further corroborated serological relationships between and among these clustered food allergies.

CONCLUSIONS:

Associations of certain food allergies were shown by DBPCFC outcomes as well as by correlations in IgE reactivity to structurally related food allergen components. Each of these criteria independently demonstrated a significant association between allergies to cashew and pistachio, as well as among allergies to walnut, pecan, and hazelnut.

KEYWORDS:

Component-resolved testing; Double-blind, placebo-controlled food challenge; IgE; Multifood allergy

PMID:
28351786
PMCID:
PMC5592131
DOI:
10.1016/j.jaip.2017.01.016
[Indexed for MEDLINE]
Free PMC Article

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