Food Allergy In Adults Research Articles

Sistem Pakar Diagnosa Penyakit Alergi Pada Anak Dengan Menggunakan Microsoft Visual Basic Net Studi Kasus Klinik Dokter Yunita Siregar

Food allergies are health problems that arise as a result of a specific immune response to food. The prevalence of food allergy in children is 6%, while in adults it is 3 - 4%. Food allergy prevention strategies that are not yet optimal are one of the causes of the increasing incidence. Immunopathogenesis in food allergies involves reactions between allergens and antibodies that are mediated by immunoglobulin E, non-immunoglobulin E, or both. The clinical implications of food allergy in adults can affect the gastrointestinal, cutaneous, respiratory, and systemic systems. The gold standard for the diagnosis of food allergy is the oral food challenge. The most appropriate treatment is to avoid trigger factors. Specific and nonspecific therapy against allergens can be given although it is still under debate.

Characteristics of Adult-Onset Food Allergy

Despite multiple studies examining food allergy prevalence and diagnosis in children, the available data on adult food allergy is limited. We sought to identify demographic characteristics and triggers of adult-onset food allergy.

Comorbidity of atopic bronchial asthma and food allergy in adults

Adult patients with atopic bronchial asthma are susceptible to food allergy, in more than one third of cases, while asthma is a risk factor for severe life-threatening factors. The aim of the study was to determine the prevalence and relationship of food allergies with atopic bronchial asthma in adults living in Chelyabinsk. Materials and methods. An analysis of 313 outpatient case histories of patients with atopic bronchial asthma over the age of 18 was performed. Results. The presence of food allergy was a factor in the earlier onset of atopic bronchial asthma, which is consistent with the concept of comorbidity of these diseases. Patients with seasonal allergic rhinitis and pollen sensitization have an increased risk of developing food allergies (OR – 2.075 [1.27- 3.39]), p=0,004. The overall incidence of oral allergic syndrome among all patients with atopic asthma and plant sensitization was 33% [28; 37]. Plant products (fruits, honey, nuts) were the cause of food allergic reactions in 87% [80; 92] of adult cases. The main clinical manifestations were: oral allergic syndrome, urticaria, angioedema, shortness of breath. Sensitization to pollen of trees, grasses and weeds approximately equally increases the risk of developing an oral allergic syndrome, upon sensitization to tree pollen (OR – 3.08 [2.32-4.25]), to grass pollen (OR – 3.5 [2.23-5.61]), to weed pollen (OR – 2.86 [2.02-4.03]). The combination of several types of pollen sensitization increases by 4 times the risk of developing oral allergic syndrome to a wide range of foods. Conclusion. Data on the causes and clinical manifestations of food allergies in combination with bronchial asthma have been obtained. The notion of a significant risk of developing dangerous clinical manifestations of food allergy in patients with atopic bronchial asthma will make it possible to reasonably prescribe emergency drugs for independent use.

Adult and Pediatric Food Allergy to Chickpea, Pea, Lentil, and Lupine: A Scoping Review

Nonpriority legume allergies, which include chickpea, pea, lentil, and lupine, are frequently implicated in severe allergic reactions. Yet, studies on public health knowledge and educational needs are near-absent. To summarize what is known from the existing literature about nonpriority legume food allergy. Eligible, original research articles reported on both nonpriority legume food allergy and 1 or more of prevalence, burden, food labeling information, or current education strategies. Screening was performed by 2 independent reviewers. Conflicts were discussed and if consensus could not be reached, a third reviewer was consulted. Of the 8976 titles identified, 47 were included subsequent to full-text screening. Most studies identified focused on prevalence, and were conducted in Europe, with additional studies from Asia, and North America. Although we defined burden quite broadly, few studies addressed the burden of nonpriority legume food allergens. Moreover, no studies addressed labeling or educational needs for these allergens. Our review of the literature found current research focused on the prevalence of nonpriority legume allergy with significant gaps regarding burden, allergen labeling, and education strategies. To this end, further research on these aspects of nonpriority legume allergy is warranted.

Development of a screening questionnaire for the study of food allergy in adults

Background & aimsAs far as we know, no screening questionnaire has been developed and validated for identification of adverse food reactions in Portuguese-speaking adults, as an initial approach towards the investigation of cases of possible food allergy. Thus, the objective of this study was to develop and validate a screening questionnaire of food allergy in adult Portuguese-speaking patients. MethodsThis was a multicentre, cross-sectional study using a simple random sample of 186 adults between 18 and 82 years old from various parts of the centre of Portugal. Intelligibility of the questionnaire was first assessed in 24 patients with confirmed IgE- or non-IgE-mediated food allergy, and in 24 volunteers without food allergies. The 17-item questionnaire was subsequently applied by phone to 78 food allergic patients (66 IgE-mediated and 12 non-IgE mediated) and to 60 non-food allergic volunteers, with subsequent reassessment (re-test). Face and content validity, intelligibility, construct validity, and test-retest reliability (temporal stability) were analysed. ResultsFace and content validity allowed item reduction from 30 to 17 items with adequate content validity index >0.78. Construct validity was confirmed in the 66 confirmed IgE-mediated food allergic patients, 12 non-IgE-mediated food allergic patients, and 60 non-allergic patients. Test-Retest Reliability (general temporal stability) of the test had a Spearman correlation coefficient value of 0.845 for the retest. Cohen's Kappa values for the relevant questions were greater than 0.890 for almost all items. No differences were found when sex, age, and volunteers' recruitment origin were analysed. An inverse relationship was found between reliability and retest time interval. ConclusionsDue to the quick and easy implementation, confirmation of face, content and construct validity as well as high temporal reproducibility, this screening questionnaire may be a useful study tool for an initial approach to detection of food allergies in adults.

The role of food atopy patch test in the diagnosis of food allergy in adults with atopic dermatitis

The role of food atopy patch test in the diagnosis of food allergy in adults with atopic dermatitis

Food allergy in adults in Europe: what can we learn from geographical differences?

The aim of this article is to characterize the present state-of-the-art on the topic of food allergies across Europe. A systematic review and metaanalysis on the epidemiology of food allergy in Europe have been performed by the Food Allergy and Anaphylaxis Guidelines Group of the European Academy of Allergology and Clinical Immunology. The authors had made an extensive search of four different electronic databases which retrieved thousands of hits. A critical appraisal of the documents reduced their number to just over 100 articles covering the period 2000-2012, revealing striking methodological inhomogeneity and blank areas on the map of the continent, particularly for the adult population. A major new development intending to fill in the gaps in the field of food allergy is the launch and implementation of the European Union-funded project 'Prevalence, Cost and Basis of Food Allergy Across Europe,' acronym 'EuroPrevall.' Among the deliverable of the project are several seminal articles on food allergy in adults which are presented in this review. The EuroPrevall project confirmed much more reliably and in more detail the existing inhomogeneity in the prevalence of food allergy, which reflects environmental and climate differences between the separate countries, but possibly also the level of public awareness.

Anxiety associated with food allergy in adults and adolescents: An analysis of data from the National Health and Nutrition Examination Survey (NHANES) 2007-2010

Anxiety associated with food allergy in adults and adolescents: An analysis of data from the National Health and Nutrition Examination Survey (NHANES) 2007-2010

Nickel allergy in lipid transfer protein sensitized patients: Prevalence and clinical features.

Nickel (Ni), the main responsible for allergic contact dermatitis worldwide, is also involved in systemic condition called “Systemic Nickel Sulfate Allergy Syndrome (SNAS).” Likewise, IgE-mediated reactivity to Lipid Transfer Protein (LTP) represents the main cause of primary food allergy in adults of Mediterranean countries. We evaluated the prevalence of SNAS in LTP allergic patients and investigated patients’ clinical features with double sensitization (LTP and Ni). A retrospective, single-center, observational study was conducted performing a complete allergological work-up including: (1) skin prick tests; (2) serum specific IgE for plant food allergens and rPru p3 (LTP); (3) patch test with 5% Ni sulfate in petrolatum. We enrolled 140 LTP allergic patients of which 36 patients (25.7% of sample) showed additional positivity to Ni patch test. Patients with double sensitization were more frequently females and reported fewer cutaneous symptoms. Higher values of sIgE for peach, apple, peanut, walnut, grain, corn, and garlic were found in LTP allergic patients, while higher values for hazelnut in the other subgroup. The prevalence of SNAS in the LTP allergic population is clinically relevant. Moreover, the clinical and immunological profiles of patients with double sensitization were different from patients monosensitized to LTP.

Preventing immediate-onset food allergy in infants, children and adults: Systematic review protocol.

More than 17 million people across Europe have allergies to food and the burden of food allergies is increasing. In 2014, the European Academy of Allergy and Clinical Immunology (EAACI) published guidelines for preventing food allergy. Important research has been published since then and it is essential to ensure the guidelines reflect the latest evidence. A systematic review will be undertaken to help prepare new guidelines due to be published in 2020. Eleven bibliographic databases will be searched from inception to 31 October 2019 for randomized controlled trials about any intervention designed to prevent the development of new cases of immediate-type/IgE-mediated food allergy in infants, children and adults. There are few randomized controlled trials about the impact of breastfeeding on food allergy so prospective cohort studies about breastfeeding with at least 1000 participants at general risk or 200 at high risk of food allergy will also be eligible. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used to assess the certainty of the evidence and tabulate summary data. The risk of bias in individual trials will be assessed using the Cochrane risk of bias tool. All data extraction and quality appraisal will be undertaken independently by two reviewers in partnership with a taskforce of EAACI members. Preventing food allergy has the potential to improve personal well-being and reduce societal healthcare costs. It is important that forthcoming European guidelines take the latest research into account. Past reviews have tended to focus on single interventions or combined food allergy with other outcomes, making it difficult to draw robust conclusions about potential impacts for policy and practice.

FOOD ALLERGY IN ADULTS INCLUDING PFAS, FDEIA, ETC.

FOOD ALLERGY IN ADULTS INCLUDING PFAS, FDEIA, ETC.

A study on self-reported food allergy in young adults from various colleges in Kerala, India

Background: Food allergy is defined as a reproducible adverse immune reaction to food proteins. Food allergies can result in life threatening reactions and diminish quality of life. In the last several decades, prevalence of food allergy has increased in several regions throughout the world.Methods: A cross sectional study was conducted among 321 young adults of the age 17 to 26 years from various colleges in Kerala. The participants were asked to fill out a pretested questionnaire. The data was collected and entered in MS Excel and analyzed.Results: Adverse reactions following food consumption was experienced by 82 respondents (25.5%). Out of these 82 respondents, 38 (46%) had their condition diagnosed by a doctor. 23 respondents had only one episode of such an attack. 41 respondents took medications for the attack. 14 respondents had been hospitalized at least once for such an attack. The most common symptoms following the consumption of food were as follows: vomiting, itching and eczema. The symptoms occur after the consumption of sea food/fish and eggs mostly. 27 respondents had a family history of food allergy.Conclusions: The symptoms of food allergy may vary from minor itching to even anaphylaxis. It is very important to know the causative allergen in the diet to prevent the occurrence of an episode of food allergy.

The Prevalence of Food Allergy in Young Israeli Adults

Information regarding the prevalence of food allergy (FA) among adults is limited due to their inaccessibility for thorough epidemiological evaluations. To evaluate the prevalence of FA among Israeli young adults. All recruits (n= 12,592, ages 17-18 years) signing up over 6 months at a single recruitment center of the Israeli army were evaluated for FA. The evaluation included a frontal interview by physicians who used a focused screening set of questions, medical documentation collection, tests of IgE reactivity, and oral food challenges. The latter were performed at an allergy care institute in ambiguous cases. A prediction model for the identification of individuals with true allergy among recruits eliminating foods due to suspected FA was developed using multivariable logistic regression. Foods elimination due to suspected FA was reported by 148 recruits (1.2%). After diagnostic testing, FA was confirmed in 0.67% (84 of 12,592). The prevalence of food elimination versus diagnosed allergy was 0.2%/0.16% milk, 0.2%/0.14% peanuts, 0.13%/0.09% fish, 0.1%/0.09% sesame, 0.04%/0.015% egg, and 0.36%/0.28% tree nuts, respectively. On multivariable logistic regression analysis, male gender (adjusted odds ratio [OR]= 3.2, 95% confidence interval [CI]: 1.4-7.7), report of a common food allergen (OR= 3.6, 95% CI: 1.4-9.3), previous allergist evaluation for FA (OR= 7.8, 95% CI: 3-20.2), and FA reactions within the past 2 years (OR= 2.8, 95% CI: 1.2-6.7) were significantly identified as independent predictors of true FA. The prevalence of FA among Israeli young adults is lower than reported for other western countries. Reliance on food elimination alone does not accurately rule in FA. The use of the identified predictors for FA can facilitate large-scale epidemiological studies in adults.

Occupational food allergy.

Occupation is an important contributing factor in the presentation of allergic disease in adults. This review article focuses on the contribution of occupation to the development and presentation of food allergies. A variety of occupations involve repeated transdermal and respiratory exposures to food-related allergens, which can result in sensitization. A sensitized individual can then manifest symptoms of food allergy after ingestion of the relevant food, even in a nonoccupational setting. Cooks and other food-processing workers bear increased risk for being sensitized to foods. Although any type of food can become a causal agent for this phenomenon, published cases of occupational food allergy concentrate on fish and seafood allergies among cooks and food-processing workers who come into direct contact with these foods. Latex-fruit syndrome is also a relatively common form of occupational food allergy among healthcare workers. Hand eczema has also been shown to be an important risk factor for occupational sensitization to food allergens. The association of occupation with food allergy in adults has been documented. Considering the under-recognized nature of this phenomenon, we should be aware in our clinical practice that a patient's occupation might be relevant to his or her food allergy.

Allergy to food in adults with allergic respiratory diseases: prevalence and clinical manifestations

Food allergy is considered a typical problem in the pediatric population, however, cases occur in adults more frequently. To determine the prevalence of food allergy in patients with allergic rhinitis and asthma; as well as the foods and symptoms most related to said problem. Through a cross-sectional study, the information of 257 adults with asthma or allergic rhinitis was analyzed. The information related to food allergy was obtained through a standardized interview; the confidence intervals (CI) were calculated for 95% proportions. The prevalence of food allergy was 17.5% (95% CI = 13.3% to 22.6%). The main foods that caused symptoms were soy, shrimp, almonds, avocado and peanuts. The majority of patients who were allergic to a single food were 35.6%, two foods were 17.8% and three foods were 17.8%. The most frequent affections of food allergy were oral (62.2%): itching of the pharynx, tongue and palate; respiratory (26.7%), dyspnea and sneezing; and skin (26.7%), itching and hives. Food allergy in adults with asthma or allergic rhinitis is a common problem. Oral symptoms are the main ailments in this type of patients and are mainly caused by soy.

Food Allergy in Adults: Substantial Variation in Prevalence and Causative Foods Across Europe

According to the community-based EuroPrevall surveys, prevalence of self-reported food allergy (FA) in adults across Europe ranges from 2% to 37% for any food and 1% to 19% for 24 selected foods. To determine the prevalence of probable FA (symptoms plus specific IgE-sensitization) and challenge-confirmed FA in European adults, along with symptoms and causative foods. In phase I of the EuroPrevall project, a screening questionnaire was sent to a random sample of the general adult population in 8 European centers. Phase II consisted of an extensive questionnaire on reactions to 24 preselected commonly implicated foods, and measurement of specific IgE levels. Multiple imputation was performed to estimate missing symptom and serology information for nonresponders. In the final phase, subjects with probable FA were invited for double-blind placebo-controlled food challenge. Prevalence of probable FA in adults in Athens, Reykjavik, Utrecht, Lodz, Madrid, and Zurich was respectively 0.3%, 1.4%, 2.1%, 2.8%, 3.3%, and 5.6%. Oral allergy symptoms were reported most frequently (81.6%), followed by skin symptoms (38.2%) and rhinoconjunctivitis (29.5%). Hazelnut, peach, and apple were the most common causative foods in Lodz, Utrecht, and Zurich. Peach was also among the top 3 causative foods in Athens and Madrid. Shrimp and fish allergies were relatively common in Madrid and Reykjavik. Of the 55 food challenges performed, 72.8% were classified as positive. FA shows substantial geographical variation in prevalence and causative foods across Europe. Although probable FA is less common than self-reported FA, prevalence still reaches almost 6% in parts of Europe.

Allergen Recognition Patterns in Walnut Allergy Are Age Dependent and Correlate with the Severity of Allergic Reactions

Walnut is an important elicitor of food allergy in children and adults with a high rate of severe reactions. Multicenter studies using a common clinical protocol and a comprehensive allergen are lacking. To investigate potential correlations between molecular sensitization patterns and clinical characteristics of walnut-allergic patients. A total of 91 walnut-allergic subjects and 24tolerant controls from Switzerland, Germany, and Spain were included. Walnut allergy was established by food challenge in all but anaphylactic subjects. Specific IgE (sIgE) to walnut extract, rJug r 1 (2S albumin), rJug r 3 (nonspecific lipid transfer protein 1), nJug r 4 (11S globulin), rJug r 5 (PR-10 protein), 2vicilin fractions, profiling, and cross-reactive carbohydrate determinant was determined by ImmunoCAP. A threshold of 0.10 kUA/L was used for positivity. Sensitivity of sIgE to walnut extract was 87% and increased to 96% for the sum of all walnut components. sIgE to walnut extract and all walnut components, except rJug r 5, was significantly higher in patients younger than 14 years at inclusion. Stratification by age at onset of walnut allergy led to similar results. All patients younger than 14 years had severe reactions, whereas 38% of patients 14 years or older were mild reactors. Severe reactors (n= 70) had higher sIgE levels than did mild reactors (n= 21) to walnut extract (P < .0001), rJug r 1 (P<.0001), nJug r 4 (P= .0003), and both vicilin fractions (P<.0001), but not to Jug r 3 and Jug r 5. Sensitization to walnut storage proteins is acquired in childhood and correlates with severe reactions. sIgE levels to storage proteins Jug r 1 and Jug r 4 and vicilin fractions, but not to nonspecific lipid transfer protein and PR-10 proteins, correlate with systemic reactions to walnut.

Clinical Features and Culprit Food Allergens of Korean Adult Food Allergy Patients: A Cross-Sectional Single-Institute Study.

PurposeTo investigate the causative allergens and clinical characteristics of Korean adult patients with food allergy (FA).MethodsThis retrospective, cross-sectional single-institutional study enrolled Korean adult patients (n = 812) suspected of having FA. For diagnosis, causality assessment history taking, ImmunoCAP specific immunoglobulin E measurement and/or skin prick test were performed.ResultsAmong 812 patients, 415 were diagnosed as having FA. The most common causative allergen was fruit, with a diagnosis of pollen food allergy syndrome (PFAS: 155, 37.3%), followed by crustaceans (111, 26.7%), wheat (63, 15.1%), fruits in patients without PFAS(43, 10.3%), buckwheat (31, 7.4%), peanut (31, 7.4%), walnut (25, 6.0%), red meat due to reaction to galactose-α-1,3-galactose (α-Gal) (8, 1.9%), and silkworm pupa (13, 3.1%). Allergy to egg, milk, fish, or shellfish was rare in Korean adults. One-third of patients with FA exhibited multiple FAs (238/415, 57.3%); the average number of causative allergens was 2.39. About 129 patients (31.0%) were diagnosed as having anaphylaxis; in these patients, wheat was the most frequent causative food. Twenty patients were further diagnosed with food-dependent exercise-induced anaphylaxis (FDEIA); all were due to wheat. In particular, crustaceans, wheat, PFAS, buckwheat, and red meat (α-Gal) were also frequent causes of anaphylaxis.ConclusionsWheat, fruits with or without PFAS, and crustaceans are important and frequent causative allergens in Korean adult FA; these allergens differ from those found in childhood FA. It is notable that non-classic allergies, such as PFAS, FDEIA, and α-Gal allergy, are the important causes of anaphylaxis in Korean adult FA.

PREVALENCE, SEVERITY, AND DISTRIBUTION OF ADULT-ONSET FOOD ALLERGY

Introduction While much attention has been devoted to food allergy in children, little is known about the prevalence and characteristics of food allergy in adults. Moreover, recent research has shown that increasing numbers of individuals are developing food allergy in adulthood. This population-based study was conducted to examine the prevalence, severity, and distribution of adult-onset food allergy. Methods A survey was administered to 40,443 adult United States residents between 2015 and 2016. Population-level prevalence was estimated using complex survey weighting. Demographics, history of reactions and diagnosis for each allergen, and comorbid conditions were analyzed. Self-reported food allergies were considered convincing if symptoms were consistent with IgE-mediated reactions. Results Among all adults with food allergy, 45.3% reported developing at least one food allergy after 18 years of age. Of these, 24.9% only experienced onset of food allergy in adulthood, and 54.7% only experienced onset of food allergy in childhood. The five most prevalent adult-onset food allergies included shellfish (13.3% of adults), milk (6.0%), wheat (5.6%), tree nut (4.8%), and soy (3.9%). More than half of individuals with adult-onset allergy to peanut, tree nut, fin fish, or shellfish reported a prior severe reaction to the allergen. Factors associated with development of adult-onset food allergy include female sex, increasing age, and a history of multiple food allergies, allergic rhinitis, or medication allergy. Conclusions One in four adults with food allergy develop a food allergy for the first time as an adult. Further study is necessary to understand potential predictors of adult-onset food allergy. While much attention has been devoted to food allergy in children, little is known about the prevalence and characteristics of food allergy in adults. Moreover, recent research has shown that increasing numbers of individuals are developing food allergy in adulthood. This population-based study was conducted to examine the prevalence, severity, and distribution of adult-onset food allergy. A survey was administered to 40,443 adult United States residents between 2015 and 2016. Population-level prevalence was estimated using complex survey weighting. Demographics, history of reactions and diagnosis for each allergen, and comorbid conditions were analyzed. Self-reported food allergies were considered convincing if symptoms were consistent with IgE-mediated reactions. Among all adults with food allergy, 45.3% reported developing at least one food allergy after 18 years of age. Of these, 24.9% only experienced onset of food allergy in adulthood, and 54.7% only experienced onset of food allergy in childhood. The five most prevalent adult-onset food allergies included shellfish (13.3% of adults), milk (6.0%), wheat (5.6%), tree nut (4.8%), and soy (3.9%). More than half of individuals with adult-onset allergy to peanut, tree nut, fin fish, or shellfish reported a prior severe reaction to the allergen. Factors associated with development of adult-onset food allergy include female sex, increasing age, and a history of multiple food allergies, allergic rhinitis, or medication allergy. One in four adults with food allergy develop a food allergy for the first time as an adult. Further study is necessary to understand potential predictors of adult-onset food allergy.

Allergen immunotherapy for oral allergy syndrome: what is the evidence for efficacy?

Background The vast majority of IgE-mediated food allergies in adults are based on sensitization to pollen and subsequent cross-reactions to structurally related allergens in fruit, vegetables, and spices. The effect of allergen immunotherapy (AIT) against pollen on pollen-related food allergy has not been conclusively elucidated.