Allergy, Asthma & Immunology Research

The Korean Academy of Asthma, Allergy and Clinical Immunology (대한천식알레르기학회)
권호 표지
DOI QR코드

DOI QR Code

Age-Based Causes and Clinical Characteristics of Immediate-Type Food Allergy in Korean Children

  • Jeong, Kyunguk (Department of Pediatrics, Ajou University School of Medicine) ;
  • Kim, Jihyun (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ahn, Kangmo (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, So-Yeon (Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Min, Taek Ki (Department of Pediatrics, Soonchunhyang University Hospital) ;
  • Pyun, Bok Yang (Department of Pediatrics, Soonchunhyang University Hospital) ;
  • Kim, Yoon Hee (Department of Pediatrics, Severance Hospital, Institute of Allergy, Yonsei University College of Medicine) ;
  • Kim, Kyung Won (Department of Pediatrics, Severance Hospital, Institute of Allergy, Yonsei University College of Medicine) ;
  • Sohn, Myung Hyun (Department of Pediatrics, Severance Hospital, Institute of Allergy, Yonsei University College of Medicine) ;
  • Kim, Kyu-Earn (Department of Pediatrics, Severance Hospital, Institute of Allergy, Yonsei University College of Medicine) ;
  • Jang, Gwang Cheon (Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital) ;
  • Song, Tae-Won (Department of Pediatrics, Inje University Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kim, Jung Hee (Department of Pediatrics, Inha University Hospital) ;
  • Jeon, You Hoon (Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Lee, Yong Ju (Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Park, Yong Mean (Department of Pediatrics, Konkuk University School of Medicine) ;
  • Yum, Hye Yung (Department of Pediatrics, Atopy Clinic, Seoul Medical Center) ;
  • Kim, Hyun Hee (Department of Pediatrics, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Woo Kyung (Department of Pediatrics, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Lee, Sooyoung (Department of Pediatrics, Ajou University School of Medicine)
  • Received : 2016.11.17
  • Accepted : 2017.04.24
  • Published : 2017.09.01
⟨ Previous Next ⟩

Abstract

Purpose: Age-based causes and clinical characteristics of immediate-type food allergy (FA) have not been sufficiently studied. Therefore, we investigated age-dependent clinical profiles of FA in Korean children through an extensive multicenter investigation. Methods: Using a case report form developed by the authors, a retrospective medical record review was performed of patients (0-18 years old) diagnosed with immediate-type FA between September 2014 and August 2015 in 14 tertiary hospitals in Korea. Results: A total of 1,353 children and adolescents, 93% younger than 7 years, were enrolled in the present study, and 1,661 cases of immediate-type FA were recorded in these patients. The 7 major causative foods were cow's milk (28.1%), hen's eggs (27.6%), wheat (7.9%), walnuts (7.3%), peanuts (5.3%), buckwheat (1.9%), and shrimps (1.9%). Categorizing the patients into 4 age groups revealed that the most common causative food was different for each age group: cow's milk (<2 years), walnuts (2-6 years), walnuts (7-12 years), and buckwheat (13-18 years). The onset time of symptoms was less than 10 minutes in 49%, between 10 and 30 minutes in 17%, and between 30 minutes and 2 hours in 34% of cases. Food-induced anaphylaxis was reported in 506 (30.5%) out of 1,661 cases, and the 7 major causes of food-induced anaphylaxis was cow's milk (27.5%), hen's eggs (21.9%), wheat (11.3%), walnuts (10.5%), peanuts (5.9%), buckwheat (4.2%), and pine nuts (3.0%). The proportion of anaphylaxis was highest in the patients allergic to buckwheat (67.7%), followed by those allergic to pine nuts (57.7%), walnuts (43.8%), wheat (43.5%), and peanuts (34.1%). Conclusions: The 5 major causative foods of immediate-type FA in Korean children were cow's milk, hen's eggs, wheat, walnuts, and peanuts. The distribution of causative foods was considerably distinctive according to different age groups. Anaphylaxis was reported in 30.5% of immediate-type FA cases.

Keywords

Acknowledgement

Supported by : Korea Ministry of Food and Drug Safety (MFDS)

References

  1. Longo G, Berti I, Burks AW, Krauss B, Barbi E. IgE-mediated food allergy in children. Lancet 2013;382:1656-64. https://doi.org/10.1016/S0140-6736(13)60309-8
  2. Sanchez-Garcia S, Cipriani F, Ricci G. Food allergy in childhood: phenotypes, prevention and treatment. Pediatr Allergy Immunol 2015;26:711-20. https://doi.org/10.1111/pai.12514
  3. Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, et al. The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics 2011;128:e9-17. https://doi.org/10.1542/peds.2011-0204
  4. Rona RJ, Keil T, Summers C, Gislason D, Zuidmeer L, Sodergren E, et al. The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol 2007;120:638-46. https://doi.org/10.1016/j.jaci.2007.05.026
  5. Soller L, Ben-Shoshan M, Harrington DW, Fragapane J, Joseph L, St Pierre Y, et al. Overall prevalence of self-reported food allergy in Canada. J Allergy Clin Immunol 2012;130:986-8. https://doi.org/10.1016/j.jaci.2012.06.029
  6. Johnson J, Malinovschi A, Alving K, Lidholm J, Borres MP, Nordvall L. Ten-year review reveals changing trends and severity of allergic reactions to nuts and other foods. Acta Paediatr 2014;103:862-7. https://doi.org/10.1111/apa.12687
  7. Park M, Kim D, Ahn K, Kim J, Han Y. Prevalence of immediate-type food allergy in early childhood in Seoul. Allergy Asthma Immunol Res 2014;6:131-6. https://doi.org/10.4168/aair.2014.6.2.131
  8. Flokstra-de Blok BM, Dubois AE, Vlieg-Boerstra BJ, Oude Elberink JN, Raat H, DunnGalvin A, et al. Health-related quality of life of food allergic patients: comparison with the general population and other diseases. Allergy 2010;65:238-44. https://doi.org/10.1111/j.1398-9995.2009.02121.x
  9. Hill DA, Grundmeier RW, Ram G, Spergel JM. The epidemiologic characteristics of healthcare provider-diagnosed eczema, asthma, allergic rhinitis, and food allergy in children: a retrospective cohort study. BMC Pediatr 2016;16:133. https://doi.org/10.1186/s12887-016-0673-z
  10. Nowak-Wegrzyn A, Sampson HA. Adverse reactions to foods. Med Clin North Am 2006;90:97-127. https://doi.org/10.1016/j.mcna.2005.08.012
  11. Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A, et al. Second symposium on the definition and management of anaphylaxis: summary report--Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol 2006; 117:391-7. https://doi.org/10.1016/j.jaci.2005.12.1303
  12. Akiyama H, Imai T, Ebisawa M. Japan food allergen labeling regulation--history and evaluation. Adv Food Nutr Res 2011;62:139-71.
  13. Crespo JF, Pascual C, Burks AW, Helm RM, Esteban MM. Frequency of food allergy in a pediatric population from Spain. Pediatr Allergy Immunol 1995;6:39-43. https://doi.org/10.1111/j.1399-3038.1995.tb00256.x
  14. Imamura T, Kanagawa Y, Ebisawa M. A survey of patients with self-reported severe food allergies in Japan. Pediatr Allergy Immunol 2008;19:270-4. https://doi.org/10.1111/j.1399-3038.2007.00621.x
  15. Ferrari GG, Eng PA. IgE-mediated food allergies in Swiss infants and children. Swiss Med Wkly 2011;141:w13269.
  16. Namork E, Fæste CK, Stensby BA, Egaas E, Lovik M. Severe allergic reactions to food in Norway: a ten year survey of cases reported to the food allergy register. Int J Environ Res Public Health 2011;8: 3144-55. https://doi.org/10.3390/ijerph8083144
  17. Makinen-Kiljunen S, Haahtela T. Eight years of severe allergic reactions in Finland: a register-based report. World Allergy Organ J 2008;1:184-9. https://doi.org/10.1097/WOX.0b013e3181898224
  18. Chen W, Mempel M, Schober W, Behrendt H, Ring J. Gender difference, sex hormones, and immediate type hypersensitivity reactions. Allergy 2008;63:1418-27. https://doi.org/10.1111/j.1398-9995.2008.01880.x
  19. Uekert SJ, Akan G, Evans MD, Li Z, Roberg K, Tisler C, et al. Sex-related differences in immune development and the expression of atopy in early childhood. J Allergy Clin Immunol 2006;118:1375-81. https://doi.org/10.1016/j.jaci.2006.09.008
  20. Pyrhonen K, Nayha S, Kaila M, Hiltunen L, Laara E. Occurrence of parent-reported food hypersensitivities and food allergies among children aged 1-4 yr. Pediatr Allergy Immunol 2009;20:328-38. https://doi.org/10.1111/j.1399-3038.2008.00792.x
  21. Kim HO, Cho SI, Kim JH, Chung BY, Cho HJ, Park CW, et al. Food hypersensitivity in patients with childhood atopic dermatitis in Korea. Ann Dermatol 2013;25:196-202. https://doi.org/10.5021/ad.2013.25.2.196
  22. Sicherer SH, Munoz-Furlong A, Godbold JH, Sampson HA. US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up. J Allergy Clin Immunol 2010;125:1322-6. https://doi.org/10.1016/j.jaci.2010.03.029
  23. Mousan G, Kamat D. Cow's milk protein allergy. Clin Pediatr (Phila) 2016;55:1054-63. https://doi.org/10.1177/0009922816664512
  24. Dogruel D, Bingol G, Altintas DU, Yilmaz M, Guneser Kendirli S. Clinical features of food allergy during the 1st year of life: the ADAPAR Birth Cohort Study. Int Arch Allergy Immunol 2016;169: 171-80. https://doi.org/10.1159/000444639
  25. Mehl A, Wahn U, Niggemann B. Anaphylactic reactions in children--a questionnaire-based survey in Germany. Allergy 2005;60: 1440-5. https://doi.org/10.1111/j.1398-9995.2005.00909.x
  26. de Silva IL, Mehr SS, Tey D, Tang ML. Paediatric anaphylaxis: a 5 year retrospective review. Allergy 2008;63:1071-6. https://doi.org/10.1111/j.1398-9995.2008.01719.x
  27. Worm M, Moneret-Vautrin A, Scherer K, Lang R, Fernandez-Rivas M, Cardona V, et al. First European data from the network of severe allergic reactions (NORA). Allergy 2014;69:1397-404. https://doi.org/10.1111/all.12475
  28. Sicherer SH, Furlong TJ, DeSimone J, Sampson HA. The US Peanut and Tree Nut Allergy Registry: characteristics of reactions in schools and day care. J Pediatr 2001;138:560-5. https://doi.org/10.1067/mpd.2001.111821
  29. Munoz-Furlong A, Weiss CC. Characteristics of food-allergic patients placing them at risk for a fatal anaphylactic episode. Curr Allergy Asthma Rep 2009;9:57-63. https://doi.org/10.1007/s11882-009-0009-2
  30. Gallagher M, Worth A, Cunningham-Burley S, Sheikh A. Strategies for living with the risk of anaphylaxis in adolescence: qualitative study of young people and their parents. Prim Care Respir J 2012; 21:392-7. https://doi.org/10.4104/pcrj.2012.00072
  31. Imai T, Sugizaki C, Ebisawa M. A report on 2011 Nationwide Survey of Immediate Type Food Allergies in Japan (supported by a grant from “Consumer Affairs Agency, Government of Japan”). Arerugi 2016;65:942-6.
  32. Grabenhenrich LB, Dolle S, Moneret-Vautrin A, Kohli A, Lange L, Spindler T, et al. Anaphylaxis in children and adolescents: the European Anaphylaxis Registry. J Allergy Clin Immunol 2016;137: 1128-1137.e1. https://doi.org/10.1016/j.jaci.2015.11.015
  33. Lee SY, Ahn K, Kim J, Jang GC, Min TK, Yang HJ, et al. A multicenter retrospective case study of anaphylaxis triggers by age in Korean children. Allergy Asthma Immunol Res 2016;8:535-40. https://doi.org/10.4168/aair.2016.8.6.535
  34. Lee SY. IgE mediated food allergy in Korean children: focused on plant food allergy. Asia Pac Allergy 2013;3:15-22. https://doi.org/10.5415/apallergy.2013.3.1.15
  35. Wieslander G, Norback D. Buckwheat allergy. Allergy 2001;56:703-4. https://doi.org/10.1034/j.1398-9995.2001.056008703.x
  36. Park K, Jeong K, Lee S. Clinical and laboratory findings of childhood buckwheat allergy in a single tertiary hospital. Korean J Pediatr 2016;59:402-7. https://doi.org/10.3345/kjp.2016.59.10.402
  37. Finkelman FD. Peanut allergy and anaphylaxis. Curr Opin Immunol 2010;22:783-8. https://doi.org/10.1016/j.coi.2010.10.005
  38. Skripak JM, Wood RA. Peanut and tree nut allergy in childhood. Pediatr Allergy Immunol 2008;19:368-73. https://doi.org/10.1111/j.1399-3038.2008.00723.x
  39. Bock SA, Munoz-Furlong A, Sampson HA. Fatalities due to anaphylactic reactions to foods. J Allergy Clin Immunol 2001;107:191-3. https://doi.org/10.1067/mai.2001.112031

Cited by

  1. Clinical characteristics and causative food types of immediate-type cow's milk and egg white allergy in children vol.5, pp.6, 2017, https://doi.org/10.4168/aard.2017.5.6.351
  2. The past, present, and future of research on anaphylaxis in Korean children vol.6, pp.suppl1, 2017, https://doi.org/10.4168/aard.2018.6.s1.s21
  3. The past, present, and future of the research on food allergy in Korean children vol.6, pp.suppl1, 2017, https://doi.org/10.4168/aard.2018.6.s1.s44
  4. Bifidobacterium lactis Ameliorates the Risk of Food Allergy in Chinese Children by Affecting Relative Percentage of Treg and Th17 Cells vol.2018, pp.None, 2017, https://doi.org/10.1155/2018/4561038
  5. ALERGIA AO LEITE DE VACA: MECANISMO, DIAGNÓSTICO E PERSPECIVAS BIOTECNOLÓGICAS vol.30, pp.1, 2017, https://doi.org/10.14450/2318-9312.v30.e1.a2018.pp60-66
  6. Epidemiology of food allergy in Korean children vol.6, pp.1, 2017, https://doi.org/10.4168/aard.2018.6.1.4
  7. Milk-Related Symptoms and Immunoglobulin E Reactivity in Swedish Children from Early Life to Adolescence vol.10, pp.5, 2017, https://doi.org/10.3390/nu10050651
  8. Food Allergen Management in Industry vol.22, pp.4, 2017, https://doi.org/10.13050/foodengprog.2018.22.4.283
  9. The School Meal Workers' Recognition and Management of Food Allergy in Gangwon Province vol.28, pp.6, 2017, https://doi.org/10.17495/easdl.2018.12.28.6.391
  10. Allergen immunotherapy for food allergy from the Asian perspective: key challenges and opportunities vol.15, pp.2, 2017, https://doi.org/10.1080/1744666x.2019.1554432
  11. The current status and issue of food allergen labeling in Korea vol.7, pp.2, 2017, https://doi.org/10.4168/aard.2019.7.2.67
  12. Clinical and Laboratory Predictors of Egg Allergy Resolution in Children vol.11, pp.4, 2019, https://doi.org/10.4168/aair.2019.11.4.446
  13. Anaphylaxis – Lessons learnt when East meets West vol.30, pp.7, 2017, https://doi.org/10.1111/pai.13098
  14. 서울시 일부 아동의 식품알레르기 위험요인 : 식품 섭취와 환경적 요인을 중심으로 vol.52, pp.6, 2017, https://doi.org/10.4163/jnh.2019.52.6.559
  15. Causes of food allergy according to age and severity: A recent 10-year retrospective study from a single tertiary hospital vol.8, pp.2, 2017, https://doi.org/10.4168/aard.2020.8.2.80
  16. Red meat allergy: clinical characteristics vol.8, pp.3, 2020, https://doi.org/10.4168/aard.2020.8.3.142
  17. A Review on Epidemiological and Clinical Studies on Buckwheat Allergy vol.10, pp.3, 2017, https://doi.org/10.3390/plants10030607
  18. 강동구 어린이급식관리지원센터 등록 시설의 식품알레르기 관리 현황 vol.26, pp.5, 2017, https://doi.org/10.5720/kjcn.2021.26.5.396