IgE-mediated food allergy in South Tunisian children: Contribution of food-specific IgE and component-resolved diagnosis

Abstract

AimWe conducted this study to assess the features of the IgE-mediated food allergies in children from Sfax hospital in South Tunisia and to study molecular component profiles for the main allergens. Patients and methodsA review of laboratory records from children seen in the hospital-based Pediatrics Department between January 2016 and June 2020 was performed. We focused on patients with positive food-specific IgE, especially those with food allergy. Diagnosis of food allergy was established by pediatricians based on description of convincing symptoms from anamnesis occuring within minutes of food comsumption. The precise molecular targets of the circulating specific IgE were identified using components resolved diagnosis (CRD) in a well-characterized group of patients. ResultsWe included 118 patients with food allergy (51% of all food-sensitized children). The mean age was 2.7 years [1 month–14 years] with a sex-ratio of m/f=2,37. Most of patients had mild symptoms without life-threatening events. Main food allergens associated with food allergy in our patients were: cow's milk, egg white and peanuts. Cow's milk allergy was the most frequent (54%) in early childhood (mean age: 2,3 years [1 month–11 years]), and 85% of patients were polysensitized to cow's milk components. Sensitization to casein was associated with anaphylaxis and/or the persistence of allergy. Egg white allergy was found in 21% of patients (mean age: 3,9 years [4 months–12 years]). Ovalbumin, ovomucoid, and ovotransferrin were the most frequent components. Sensitization to ovomucoid was associated with severity and intolerance to cooked eggs. Allergy to peanuts was less common (8%) with main sensitization to the lipid transfer protein Arah9. ConclusionSpecific IgE testing is useful in the context of food allergy and contributes to the diagnosis and management of patients. Disparities can be observed depending on the region/country. CRD is useful for diagnostic precision of food allergy.