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Organ-specific symptom patterns during oral food challenge in children with peanut and tree nut allergy.
Dobbertin-Welsch, Josefine; Staudacher, Olga; Yürek, Songül; Trendelenburg, Valérie; Tschirner, Sebastian; Ziegert, Mandy; Ahrens, Frank; Millner-Uhlemann, Martina; Büsing, Susanne; Striegel, Anne; Ott, Hagen; Arens, Alisa; Gappa, Monica; Lange, Lars; Gernert, Sunhild; Niggemann, Bodo; Beyer, Kirsten.
Afiliación
  • Dobbertin-Welsch J; Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany.
  • Staudacher O; Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany.
  • Yürek S; Department of Immunology, Labor Berlin - Charité Vivantes GmbH, Berlin, Germany.
  • Trendelenburg V; Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany.
  • Tschirner S; Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany.
  • Ziegert M; Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany.
  • Ahrens F; Department of Pediatric Allergology, German Red Cross Clinic Westend, Berlin, Germany.
  • Millner-Uhlemann M; Children's Hospital "Altona", Hamburg, Germany.
  • Büsing S; Pediatric allergology practice, Stuttgart.
  • Striegel A; Children's Hospital, Osnabrück, Germany.
  • Ott H; Children's Hospital, University of Cologne, Cologne, Germany.
  • Arens A; Division of Pediatric Dermatology and Allergology, Children's Hospital Auf der Bult, Hannover, Germany.
  • Gappa M; Division of Pediatric Dermatology and Allergology, Children's Hospital Auf der Bult, Hannover, Germany.
  • Lange L; Children's Hospital, Evangelisches Krankenhaus Düsseldorf, Formerly Marien hospital Wesel, Wesel, Germany.
  • Gernert S; Department for Pediatrics, St. Marien-Hospital, Bonn, Germany.
  • Niggemann B; Department for Pediatrics, St. Marien-Hospital, Bonn, Germany.
  • Beyer K; Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany.
Pediatr Allergy Immunol ; 33(5): e13778, 2022 05.
Article en En | MEDLINE | ID: mdl-35616889
BACKGROUND: Peanut and tree nut allergies are common in childhood and often severe in nature. The clinical picture shows a wide variety of symptoms. OBJECTIVE: To analyze the distribution of clinical symptoms and severity during oral food challenges (OFC) in children. METHODS: Analysis of 1.013 prospectively recorded, positive OFCs with peanut (n = 607), hazelnut (n = 266), walnut (n = 97), and cashew (n = 43). Symptoms were categorized as immediate-type skin, gastrointestinal, upper and lower respiratory, cardiovascular symptoms, and eczema exacerbation. Symptom severity and treatment were recorded. RESULTS: Skin symptoms presented in 78%, followed by gastrointestinal (47%), upper (42%), and lower respiratory symptoms (32%). Cardiovascular symptoms presented in 6%. In three-quarter of the reactions, more than one organ was involved. Importantly, severe reactions occurred at every dose level. Peanut- and cashew-allergic patients had a higher relative risk of gastrointestinal symptoms compared with hazelnut- and walnut-allergic patients. Patients without vomiting had a 1.7 times higher risk developing immediate-type skin and/or lower respiratory symptoms. Three-quarter of the patients ever had eczema but worsening presented in only 10.5% of the OFCs. In patients with multiple food allergies, organs involved, eliciting dose and severity differed between allergens. CONCLUSION: Although comparisons between allergen groups with different clinical history, severity, comorbidities and laboratory data are difficult and might contain bias, our data confirm the high allergenic potential of peanut and tree nuts. The rare occurrence of eczema worsening emphasizes that avoidance diets of peanuts and tree nuts to cure eczema seem to be unnecessary and may hamper tolerance maintenance.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hipersensibilidad a la Nuez / Hipersensibilidad al Cacahuete / Juglans / Eccema Tipo de estudio: Diagnostic_studies / Etiology_studies Límite: Child / Humans Idioma: En Revista: Pediatr Allergy Immunol Asunto de la revista: ALERGIA E IMUNOLOGIA / PEDIATRIA Año: 2022 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hipersensibilidad a la Nuez / Hipersensibilidad al Cacahuete / Juglans / Eccema Tipo de estudio: Diagnostic_studies / Etiology_studies Límite: Child / Humans Idioma: En Revista: Pediatr Allergy Immunol Asunto de la revista: ALERGIA E IMUNOLOGIA / PEDIATRIA Año: 2022 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido