Öz
Aims: Our study was conducted to evaluate the results of the oral food provocation tests in children with a diagnosis of food allergy and to examine the development of reactions in patients during the oral food provocation test.
Material and Method: This was a descriptive type of study. Children diagnosed with food allergy between the years 2020-2022, and who had an oral food provocation test were included in the study. The patient files were scanned retrospectively. Age, gender, allergy tests, total IgE, eosinophil values and reactions during treatment were evaluated.
Results: Oral food provocation test was applied to 40.5% (n=85) of the patients for diagnostic purposes and 59.5% (n=125) to determine the food tolerance. Of the patients who received oral provocation, 48.1% (n=101) received yogurt, 39.0% (n=82) eggs, 5.7% (n=12) baked egg cake, 4.8% (n=10), baked yoghurt cake. Reaction was observed in 8.6% (n=18) of the patients who received oral food provocation test. Reactions were mostly urticaria. There was no statistically significant relationship between the development of the reaction and gender, the purpose of the provocation test, the age of onset of the first complaints and the age at which the provocation test was applied (p>0.05). The median specific IgE (milk) value was higher in patients who developed a reaction (p=0.034).
Conclusions: Although the reactions are often mild such as urticaria, it is important to predict the development of the reaction in terms of the management of food allergies and the feasibility of the provocation test.
Anahtar Kelimeler
Kaynakça
- 1. Calvani M, Anania C, Caffarelli C, et al. Food allergy: An updated review on pathogenesis, diagnosis, prevention and management. Acta Biomed. 2020;91(Suppl 11): e2020012.
- 2. Ramírez-Marín HA, Singh AM, Ong PY, Silverberg JI. Food allergy testing in atopic dermatitis. JAAD Int. 2022;9:50-56.
- 3. Seth D, Poowutikul P, Pansare M, Kamat D. Food allergy: a review. Pediatr Ann. 2020;49(1):e50-e8.
- 4. Tercanlı E, Atasever M. Besin Alerjileri. Academic Platform Journal of Halal Lifestyle. 2021;3(1):31-53.
- 5. Calvani M, Anania C, Cuomo B, et al. Non-IgE- or Mixed IgE/Non-IgE-Mediated Gastrointestinal Food Allergies in the First Years of Life: Old and New Tools for Diagnosis. Nutrients. 2021;13(1):226.
- 6. Topal E, Çatal F, Şenbaba E, et al. Oral besin provokasyon testi sırasında gelişen reaksiyonların sıklığı ve şiddeti. Asthma Allergy Immunol. 2014;12(2):104-109.
- 7. Demirtaş MS, Topal E, Çatal F. Dört yaşındaki bir çocukta nadir bir anafilaksi nedeni: muz ile oral provokasyon testi. Ş.E.E.A.H. Tıp Bülteni. 2016;50(4):338-40.
- 8. Ballmer-Weber BK. Value of allergy tests for the diagnosis of food allergy. Dig Dis. 2014;32(1-2):84-88.
- 9. Nowak-Wegrzyn A, Assa'ad AH, Bahna SL, Bock SA, Sicherer SH, Teuber SS; Adverse Reactions to Food Committee of American Academy o f Allergy Asthma and Immunology. Work Group report oral food challenge testing. J Allergy Clin Immunol 2009;123(6 Suppl):S365-83.
- 10. Calvani M, Bianchi A, Reginelli C, Peresso M, Testa A. Oral food challenge. Medicina. 2019;55(10):651.
- 11. Rancé F, Deschildre A, Villard-Truc F, et al. Oral food challenge in children: an expert review. Eur Ann Allergy Clin Immunol. 2009;41(2):35.
- 12. Lieberman JA, Cox AL, Vitale M, Sampson HA. Outcomes of office-based, open food challenges in the management of food allergy. J Allergy Clin Immunol. 2011;128(5):1120-2.
- 13. Peters RL, Krawiec M, Koplin JJ, Santos AF. Update on food allergy. Pediatr Allergy Immunol. 2021;32(4):647-57.
- 14. Warren CM, Jiang J, Gupta RS. Epidemiology and burden of food allergy. Curr Allergy Asthma Rep. 2020;20(2):6.
- 15. Şenol HD, Köksal BT. Van’da besin alerjik çocukların klinik özellikleri. Van Tıp Dergisi. 2015;22(4):266-72.
- 16. Ito K. Diagnosis of food allergies: the impact of oral food challenge testing. Asia Pacific Allergy. 2013;3(1):59-69.
- 17. Calvani M, Berti I, Fiocchi A, et al. Oral food challenge: safety, adherence to guidelines and predictive value of skin prick testing. Pediatr Allergy Immunol. 2012;23(8):754-60.
- 18. Niggemann B. When is an oral food challenge positive? Allergy. 2010;65(1):2-6.
- 19. Perry TT, Matsui EC, Conover-Walker MK, Wood RA. Risk of oral food challenges. J Allergy Clin Immunol. 2004;114(5):1164-8.
- 20. Shek LP, Soderstrom L, Ahlstedt S, Beyer K, Sampson HA. Determination of food specific IgE levels over time can predict the development of tolerance in cow's milk and hen's egg allergy. J Allergy Clin Immunol. 2004;114(2):387-91.
Öz
Amaç: Çalışmamız, besin alerjisi tanısı alan çocuklarda oral besin provokasyon testi sonuçlarını değerlendirmek ve oral besin provokasyon testi sırasında hastalarda reaksiyon gelişimini incelemek amacıyla yapılmıştır.
Gereç ve Yöntem: Çalışma tanımlayıcı tiptedir. 2020-2022 yılları arasında besin alerjisi tanısı alan ve oral besin provokasyon testi yapılan çocuklar çalışmaya dahil edildi. Hasta dosyaları retrospektif olarak tarandı. Yaş, cinsiyet, alerji testleri, total IgE, eozinofil değerleri ve tedavi sırasındaki reaksiyonlar değerlendirildi.
Bulgular: Hastaların %40,5'ine (n=85) tanı amaçlı, %59,5'ine (n=125) gıda toleransını belirlemek için oral gıda provokasyon testi uygulandı. Oral provokasyon uygulanan hastaların %48,1'ine (n=101) yoğurt, %39,0'una (n=82) yumurta, %5,7'sine (n=12) yumurtalı kek, %4,8'ine (n=10) fırınlanmış yoğurtlu kek verildi. Oral gıda provokasyon testi yapılan hastaların %8,6'sında (n=18) reaksiyon görüldü. Görülen reaksiyonlar çoğunlukla ürtikerdi. Reaksiyon gelişimi ile cinsiyet, provokasyon testinin yapılma amacı, ilk şikayetlerin başlama yaşı ve provokasyon testinin uygulanma yaşı arasında istatistiksel olarak anlamlı bir ilişki yoktu (p>0,05). Medyan spesifik IgE (süt) değeri reaksiyon gelişen hastalarda daha yüksekti (p=0,034).
Sonuç: Oral provokasyon testi sırasında gelişen reaksiyonlar genellikle ürtiker gibi hafif olsa da, gıda alerjilerinin yönetimi ve provokasyon testinin uygulanabilirliği açısından reaksiyon gelişiminin önceden tahmin edilmesi önemlidir.
Anahtar Kelimeler
Kaynakça
- 1. Calvani M, Anania C, Caffarelli C, et al. Food allergy: An updated review on pathogenesis, diagnosis, prevention and management. Acta Biomed. 2020;91(Suppl 11): e2020012.
- 2. Ramírez-Marín HA, Singh AM, Ong PY, Silverberg JI. Food allergy testing in atopic dermatitis. JAAD Int. 2022;9:50-56.
- 3. Seth D, Poowutikul P, Pansare M, Kamat D. Food allergy: a review. Pediatr Ann. 2020;49(1):e50-e8.
- 4. Tercanlı E, Atasever M. Besin Alerjileri. Academic Platform Journal of Halal Lifestyle. 2021;3(1):31-53.
- 5. Calvani M, Anania C, Cuomo B, et al. Non-IgE- or Mixed IgE/Non-IgE-Mediated Gastrointestinal Food Allergies in the First Years of Life: Old and New Tools for Diagnosis. Nutrients. 2021;13(1):226.
- 6. Topal E, Çatal F, Şenbaba E, et al. Oral besin provokasyon testi sırasında gelişen reaksiyonların sıklığı ve şiddeti. Asthma Allergy Immunol. 2014;12(2):104-109.
- 7. Demirtaş MS, Topal E, Çatal F. Dört yaşındaki bir çocukta nadir bir anafilaksi nedeni: muz ile oral provokasyon testi. Ş.E.E.A.H. Tıp Bülteni. 2016;50(4):338-40.
- 8. Ballmer-Weber BK. Value of allergy tests for the diagnosis of food allergy. Dig Dis. 2014;32(1-2):84-88.
- 9. Nowak-Wegrzyn A, Assa'ad AH, Bahna SL, Bock SA, Sicherer SH, Teuber SS; Adverse Reactions to Food Committee of American Academy o f Allergy Asthma and Immunology. Work Group report oral food challenge testing. J Allergy Clin Immunol 2009;123(6 Suppl):S365-83.
- 10. Calvani M, Bianchi A, Reginelli C, Peresso M, Testa A. Oral food challenge. Medicina. 2019;55(10):651.
- 11. Rancé F, Deschildre A, Villard-Truc F, et al. Oral food challenge in children: an expert review. Eur Ann Allergy Clin Immunol. 2009;41(2):35.
- 12. Lieberman JA, Cox AL, Vitale M, Sampson HA. Outcomes of office-based, open food challenges in the management of food allergy. J Allergy Clin Immunol. 2011;128(5):1120-2.
- 13. Peters RL, Krawiec M, Koplin JJ, Santos AF. Update on food allergy. Pediatr Allergy Immunol. 2021;32(4):647-57.
- 14. Warren CM, Jiang J, Gupta RS. Epidemiology and burden of food allergy. Curr Allergy Asthma Rep. 2020;20(2):6.
- 15. Şenol HD, Köksal BT. Van’da besin alerjik çocukların klinik özellikleri. Van Tıp Dergisi. 2015;22(4):266-72.
- 16. Ito K. Diagnosis of food allergies: the impact of oral food challenge testing. Asia Pacific Allergy. 2013;3(1):59-69.
- 17. Calvani M, Berti I, Fiocchi A, et al. Oral food challenge: safety, adherence to guidelines and predictive value of skin prick testing. Pediatr Allergy Immunol. 2012;23(8):754-60.
- 18. Niggemann B. When is an oral food challenge positive? Allergy. 2010;65(1):2-6.
- 19. Perry TT, Matsui EC, Conover-Walker MK, Wood RA. Risk of oral food challenges. J Allergy Clin Immunol. 2004;114(5):1164-8.
- 20. Shek LP, Soderstrom L, Ahlstedt S, Beyer K, Sampson HA. Determination of food specific IgE levels over time can predict the development of tolerance in cow's milk and hen's egg allergy. J Allergy Clin Immunol. 2004;114(2):387-91.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Çocuk İmmünolojisi ve Alerji Hastalıkları |
| Bölüm | Orjinal Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 15 Ekim 2023 |
| Kabul Tarihi | 19 Eylül 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 11 Sayı: 3 |
