Abstract
Background Many patients with chronic spontaneous urticaria (CSU) identify different foods as triggers of their symptoms and frequently make dietary restrictions without enough information. Objective To explore the diet habits of CSU patients and estimate the clinical impact of the foods most frequently reported to be suspect. Methodology Patients were interrogated about their clinical history of urticaria. Skin prick test and sIgE serum were done for most frequently reported foods by patients. Food challenge test was also performed. A group of healthy subjects was included to compare the dietary habits and the results of the diagnostic tests. Results Patients with CSU (n 245) and healthy (n 127) subjects were included. 164 (66%) subjects from CSU group and 31 (24%) from the control group reported at least one adverse reaction with foods. Food IgE sensitization was similar in both groups (17.5% versus 16.5%, respectively). 410 food challenge tests in 164 CSU patients and 38 in 38 control subjects were performed. 1.2% in CSU group and 0.7% in control group had a positive oral challenge test. Conclusion Despite the high frequency of self-report by patients, foods are uncommon triggers of CSU. Nevertheless, food challenge tests have to be offered early during medical evaluation to avoid unnecessary restrictions.
Highlights
Urticaria is a common cutaneous disease, where the chronic form affects around 1% of general population and has an important impact in the quality of life
No other differences regarding general characteristics were observed between the chronic spontaneous urticaria (CSU) group and the control group
To what we had previously reported for inducible urticaria [3], in this study, we found that in more than 95% of patients with self-reported foods reactions the food was not related to the onset of symptoms
Summary
Urticaria is a common cutaneous disease, where the chronic form affects around 1% of general population and has an important impact in the quality of life. Hsu ML et al [4], observed that 32% of patients with chronic urticaria self-reported food as a possible trigger of urticaria, but after one month a restrictive diet was ineffective in 82.9% of patients. These results suggested that a self-reported evaluation is not adequate for studying some triggers of CSU. To demonstrate “a clear relationship”, challenge tests are required and most studies evaluating the prevalence of food as a cause or trigger of chronic urticaria do not include this diagnostic test. Food challenge tests have to be offered early during medical evaluation to avoid unnecessary restrictions
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