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Food allergy in children: focus on IgE-mediated food allergy

Article information

J Korean Med Assoc. 2017;60(3):242-248
Publication date (electronic) : 2017 March 23
doi : https://doi.org/10.5124/jkma.2017.60.3.242
Sooyoung Lee, MD1,2orcid_icon
1Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.
2Suwon Center for Environmental Diseases and Atopy, Suwon, Korea.
Corresponding author: Sooyoung Lee. jsjs87@ajou.ac.kr
Received 2017 January 17; Accepted 2017 January 31.

Abstract

Food allergy (FA) has become more common in recent decades, and it is a serious health problem in children. FA is divided into immunoglobulin E (IgE)-mediated and non-IgE-mediated FA based on its mechanism. FA most often develops early in life, affecting up to 10% of children, and increasing concerns have been raised regarding severe FA including food-induced anaphylaxis, especially in young children. The 2 most common food allergens worldwide are milk and eggs, while the third most common allergen varies among countries. In addition to a detailed and convincing history of diverse symptoms (involving the skin, gastrointestinal, respiratory, cardiovascular, and neurologic systems) after exposure to culprit foods, the following tools can be useful in the diagnosis of FA: the skin prick test, measurement of serum food-specific IgE antibodies, and the elimination or provocation test with suspected foods. The current recommended management of FA relies on the strict avoidance of causative foods; the immediate treatment of allergic reactions, including epinephrine use for food-induced anaphylaxis; and education to prevent further reactions. Emerging approaches for tolerance induction to FA, such as food immunotherapy, have been investigated, but concrete evidence for clinical application is lacking. This review presents a detailed overview of the pathogenesis of FA, its prevalence, common culprit foods, and its diagnosis and management, and additionally shares recent data on common causative foods in Korean infants and children.

Keywords: Food hypersensitivity; Child; Etiology; Culprit food; Therapeutics

References

1. Nowak-Wegrzyn A, Sampson HA, Sicherer SH. In : Kliegman RM, Stanton BF, St Geme JW III, Schor NF, Behrman RE, eds. Nelson textbook of pediatrics 20th edth ed. Philadelphia: Elsevier; 2016. p. 1137–1143.
2. Sicherer SH, Sampson HA. Food allergy: Epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol 2014;133:291–307.
3. Korean Academy of Pediatric Allergy and Respiratory Disease. Food allergy. Korean Academy of Pediatric Allergy and Respiratory Disease. Textbook of pediatric allergy and respiratory diseases Seoul: Ryo Moon Gak; 2013. p. 211–228.
4. Longo G, Berti I, Burks AW, Krauss B, Barbi E. IgE-mediated food allergy in children. Lancet 2013;382:1656–1664.
5. Savage J, Sicherer S, Wood R. The natural history of food allergy. J Allergy Clin Immunol Pract 2016;4:196–203.
6. Berin MC, Chehade M. Mucosal immunology: an overview. In : Leung DY, Szefler SJ, Bonilla FA, Akdis CA, Sampson HA, eds. Pediatric allergy: principles and practice 3rd edth ed. Edinburgh: Elsevier; 2016. p. 365–370.
7. Berin MC, Mayer L. Can we produce true tolerance in patients with food allergy? J Allergy Clin Immunol 2013;131:14–22.
8. Hoffmann-Sommergruber K, Mills EN. Food allergen protein families and their structural characteristics and application in component-resolved diagnosis: new data from the EuroPrevall project. Anal Bioanal Chem 2009;395:25–35.
9. Lee S. A study for prevention and control of food allergy Cheongju: Ministry of Food and Drug Safety; 2015.
10. Song TW, Kim KW, Kim WK, Kim JH, Kim HH, Park YM, Ahn K, Yang HJ, Yum HY, Lee SY, Jeon YH, Pyun BY. Guide-lines for the oral food challenges in children. Pediatr Allergy Respir Dis 2012;22:4–20.
11. Sampson HA. Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J Allergy Clin Immunol 2001;107:891–896.
12. Sohn MH, Lee SY, Kim KE. Prediction of buckwheat allergy using specific IgE concentrations in children. Allergy 2003;58:1308–1310.
13. Park K, Jeong K, Lee S. Clinical and laboratory findings of child-hood buckwheat allergy in a single tertiary hospital. Korean J Pediatr 2016;59:402–407.
14. Kim J, Kim HY, Park MR, Choi J, Shim JY, Kim MJ, Han Y, Ahn K. Diagnostic decision points of specific IgE concentrations in Korean children with egg and cow's milk allergies. Allergy Asthma Immunol Res 2015;7:332–338.
15. Min TK, Jeon YH, Yang HJ, Pyun BY. The clinical usefulness of IgE antibodies against egg white and its components in Korean children. Allergy Asthma Immunol Res 2013;5:138–142.
16. Oh JW, Pyun BY, Choung JT, Ahn KM, Kim CH, Song SW, Son JA, Lee SY, Lee SI. Epidemiological change of atopic dermatitis and food allergy in school-aged children in Korea between 1995 and 2000. J Korean Med Sci 2004;19:716–723.
17. 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;6:131–136.
18. Lee SY, Ahn K, Kim J, Jang GC, Min TK, Yang HJ, Pyun BY, Kwon JW, Sohn MH, Kim KW, Kim KE, Yu J, Hong SJ, Kwon JH, Kim SW, Song TW, Kim WK, Kim HY, Jeon YH, Lee YJ, Lee HR, Kim HY, Ahn Y, Yum HY, Suh DI, Kim HH, Kim JT, Kim JH, Park YM, Lee S. Korean Academy of Pediatric Allergy and Respiratory Diseases Food Allergy and Atopic Dermatitis Study Group. A multicenter retrospective case study of anaphylaxis triggers by age in Korean children. Allergy Asthma Immunol Res 2016;8:535–540.
19. Jeong K, Lee SY, Ahn K, Kim J, Lee HR, Suh DI, Pyun BY, Min TK, Kwon JW, Kim KE, Kim KW, Sohn MH, Kim YH, Song TW, Kwon JH, Jeon YH, Kim HY, Kim JH, Ahn YM, Lee S. A multicenter study on anaphylaxis caused by peanut, tree nuts, and seeds in children and adolescents. Allergy 2017;72:507–510.
20. Ministry of Food and Drug Safety. Allergenic Food Labeling Act 2015 Cheongju: Ministry of Food and Drug Safety; 2015.
21. Song TW. A practical view of immunotherapy for food allergy. Korean J Pediatr 2016;59:47–53.
22. Leonard SA, Sampson HA, Sicherer SH, Noone S, Moshier EL, Godbold J, Nowak-Wegrzyn A. Dietary baked egg accelerates resolution of egg allergy in children. J Allergy Clin Immunol 2012;130:473–480.

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Table 1

Usual age at onset and resolution of food allergy in children

Table 1

Modified from Kliegman RM et al. Nelson textbook of pediatrics. 20th ed. Philadelphia: Elsevier; 2016 [1].

Table 2

Foods considering during elimination diet due to cross reaction

Table 2

Modified from Korean Academy of Pediatric Allergy and Respiratory Disease. Textbook of pediatric allergy and respiratory diseases. Seoul: Ryo Moon Gak; 2013 [3].