African American Race Is a Robust Risk Factor for Food, but Not Aeroallergen Sensitization

Abstract

FEBRUARY 2013 AB24 Abstracts S A T U R D A Y 86 Prevalence of Milk, Peanut and Egg Allergies in A Socioeconomically Diverse Cohort of Infants: Identifying Cases of Food Allergy for Field Studies Using an Expert Panel Jerel M. Ezell, MPH, Suzanne Havstad, MA, Haejin Kim, MD, Ganesa Wegienka, PhD, Dennis Ownby, MD, FAAAAI, Edward M. Zoratti, MD, FAAAAI, Christine Cole Johnson, PhD, MPH, FAAAAI, Christine L. M. Joseph, PhD; Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, Division of Allergy and Clinical Immunology, Henry Ford Hospital, Detroit, MI, Division of Allergy-Immunology and Rheumatology, Georgia Health Sciences University, Augusta, GA. RATIONALE: Double-blind, placebo-controlled oral food challenges remain the gold standard for identifying cases of food allergy, but are seldom feasible for large, epidemiologic studies. We used an expert panel to ascertain food allergy in a birth cohort. METHODS: Determination of Immunoglobulin-E-mediated food allergy (FA) to milk, peanut and egg in infants age 24 months was made by two board-certified allergists who categorized cases as highly probable, likely and unlikely. A third allergist was consulted for discordant reviews. Panelists reviewed cord blood IgEmeasures; parent interviews at 1, 6, 12, and 24 months, including family history of allergy/asthma; a 36-month parent interview including items on food avoidance, gastrointestinal symptoms, onset and duration of reactions to food; infant medical records; and serum-specific IgE and skin prick test results at 24 months. RESULTS: Of the 587 infants analyzed, the panel reviewed 280 cases and agreed on 220 (78.6%). The remaining 60 cases (21.4%) were decided by a third allergist. Overall, 52 infants (8.9%) had highly probable/likely cases of FA based on panel consensus. Prevalence of milk, peanut, and egg allergies was 1.7% (0.8-3.1), 5.3% (3.6-7.4) and 6.1% (4.3-8.4), respectively. In comparison, prevalence of sensitization to these food allergens was 31.6%, 11.6%, and 24.5%, respectively. Prevalence was highest for African Americans. Panelists took 1.7 minutes, on average, to review each case. CONCLUSIONS: As expected, not all sensitized infants were found to have a corresponding FA. Usage of an expert panel provides a systematic approach to identifying cases of FA in epidemiologic studies.