Ersoy CİVELEK, Betül BÜYÜKTİRYAKİ, İlknur KÜLHAŞ ÇELİK, Can Naci KOCABAŞ, Emine DİBEK MISIRLIOĞLU, Muge TOYRAN, Emine Sena ALABOYUN, Tayfur GİNİŞ

Besin ile Tetiklenen Atopik Dermatitli Bir Yaş Altı Çocukların Besin Duyarlılık Paternleri

Amaç: Atopik dermatitli hastaların besin alerjeni duyarlılık paternleri ülkeler arasında arasında değişiklik gösterir. Bu çalışmanın amacı, besin ile tetiklenen atopik dermatitli bir yaş altı çocukların gıda duyarlılık paternlerini belirlemektir. Gereç ve Yöntemler: Çalışmamızda hastanemiz Çocuk Alerji ve İmmünoloji Kliniğinde takip edilen atopik dermatitli hastalar retrospektif olarak değerlendirildi. Bu hastalar arasında hem pozitif deri prik testi hem de gıdaya spesifik serum IgE pozitifliği olanlar çalışmaya dahil edildi. Besin duyarlılığının tanısı, eliminasyon diyeti ile düzelme olması ile doğrulandı. Bulgular: İki yüz dört (% 74.5 erkek) 1 yaşından küçük atopik dermatit hastasında besin ile tetiklenen-atopik dermatit olduğu tespit edildi. Tanı sırasındaki ortanca yaş 3 aydı (çeyrekler arası aralık: 1-5.87). Deri prik testi ve serum spesifik IgE sonuçları incelendiğinde ;%85.8 oranında yumurta ,%35.5 oranında süt, %3.9 oranında buğday, % 1.5 oranında ceviz, %2.5 oranında fıstık ve %2 oranında balık duyarlılığı tespit edildi. Hiçbir hastada soya duyarlılığı gözlenmedi. Sonuç: Bulgularımız hastalarımızın büyük bir kısmının erkek olduğunu, yumurtanın en yaygın besin duyarlılığı olduğunu, fıstık duyarlılığının prevalansının diğer ülkelere göre daha az olduğunu ve hiçbir hastamızın soya duyarlılığına sahip olmadığını gösterdi. Anahtar Sözcükler: Atopik dermatit, Çocuklar, Besin duyarlılığı

Anahtar Kelimeler:

atopik dermatit, çocuklar, besin duyarlılığı

Food Sensitization Patterns of Infants with Food-Triggered Atopic Dermatitis

Objective: Food allergen sensitization patterns vary among patients with atopic dermatitis in different countries. The aim of this study was to determine the food sensitization patterns of infants with food-triggered atopic dermatitis. Material and Methods: The study was a retrospective evaluation of atopic dermatitis patients who were followed at the Pediatric Allergy and Immunology Clinic of our hospital. Among these patients, those who had both positive skin prick test and positive serum specific IgE to a food were included in the study. The diagnosis of food sensitization was confirmed upon improvement with an elimination diet Results: A total of 204(74.5% boys) atopic dermatitis patients less than 1 year of age were found to have food-trigerred atopic dermatitis. Median age at diagnosis was 3 months(interquartile range: 1-5.8). When skin prick test and serum specific IgE results were analyzed, we found sensitivity to egg in 85.8%, milk in 35.5%, wheat in 3.9%, walnut in 1.5%, peanut in 2.5%, and fish in 2% of the patients. None of the patients showed sensitivity to soybean. Conclusion: Our findings indicated that a large portion of our patients were male, egg was the most common food sensitivity, the prevalence of peanut sensitivity was less than other countries and none of the patients had soy sensitivity.

Keywords:

atopic dermatitis, children, food sensitization,

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References: 1. Eichenfield LF, Ahluwalia J, Waldman A, Borok J, Jeremy Udkoff J, Boguniewicz M. Current guidelines for the evaluation and management of atopic dermatitis: A comparison of the Joint Task Force Practice Parameter and American Academy of Dermatology guidelines. J Allergy Clin Immunol. 2017;139(4):49-S57. 2. Beasley R. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet 1998;351:1225-32. 3. Roduit C, Frei R, Loss G, Buchele G, Weber J, Depner M, et al. Development of atopic dermatitis according to age of onset and association with early-life exposures. J Allergy Clin Immunol 2012;130:130-136.e5. 4. Shaw TE, Currie GP, Koudelka CW, Simpson EL. Eczema prevalence in the United States: data from the 2003 National Survey of Children’s Health. J Invest Dermatol 2011;131:67-73. 5. Kay J, Gawkrodger DJ, Mortimer MJ, Jaron AG. The prevalence of childhood atopic eczema in a general population. J Am Acad Dermatol 1994;30:35-9. 6. Palmer CN, Irvine AD, Terron-Kwiatkowski A, Zhao Y, Liao H, Lee SP, et al. Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet 2006;38:441-6. 7. Eigenmann P, Sicherer S, Borkowski T, Cohen B, Sampson H. Prevalence of IgE-mediated food allergy among children with atopic dermatitis. Pediatrics 1998;101:E8. 8. Eigenmann PC, Calza AM. Diagnosis of IgE-mediated food allergy among Swiss children with atopic dermatitis. Pediatric Allergy Immunol 2000;11:95-100. 9. Burks AW, James JM, Hiegel A, Wilson G, Wheeler JG, Jones SM, et al. Atopic dermatitis and food hypersensitivity reactions. J Pediatr 1998:132-6. 10. Forbes LR, Saltzman RW, Spergel JM. Food allergies and atopic dermatitis: differentiating myth from reality. Pediatr Ann 2009;38:84-90. 11. Bergmann MM, Caubet JC, Boguniewicz M, Eigenmann PA . Evaluation of food allergy in patients with atopic dermatitis. J Allergy Clin Immunol Pract. 2013 Jan;1(1):22-8 12. de Benedictis FM, Franceschini F, Hill D, Naspitz C, Simons FE, Wahn U, Warner JO, de Longueville M; EPAAC Study Group. The allergic sensitization in infants with atopic eczema from diﬀerent countries. Allergy. 2009 ;64(2):295-303. 13. Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Dermato-Venereologica 1980; 92:44-47 14. Atherton DJ, Sweel M, Soothill JF, Wells RS, Chilvers CE. A double-blind controlled crossover trial of an antigen-avoidance diet in atopic eczema. Lancet 1978;1:401-3. 15. Bergmann MM, Caubet JC, Boguniewicz M, Eigenmann PA. Evaluation of food allergy in patients with atopic dermatitis. J Allergy Clin Immunol Pract. 2013;1(1):22-8. 16. du Toit G., Roberts G., Sayre P.H., Bahnson H.T., Radulovic S., Santos A.F., et al: Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med 2015;372:803-813 17. Perkin M.R., Logan K., Tseng A., Raji B., Ayis S., Peacock J., et al: Randomized trial of introduction of allergenic foods in breastfed infants. N Engl J Med 2016;374(18):1733-43. 18.Sisherer SH, Sampson HA. Food Hypersensitivity and atopic dermatitis : pathophysiology, epidemiology, diagnosis, and management. J Allergy Clin Immunol. 1999 ;104(3 Pt 2):114-22.
19. Chang A, Robison RA, Cai M, Singh AM. Natural History of Children with Food Triggered Atopic Dermatitis and Development of Immediate Reactions. J Allergy Clin Immunol. 2015;2: 229-236 20. Knox SM, Erwin EA, Joy L. Mosser-Goldfarb, Rebecca Scherzer. Sensitization patterns among patients with atopic dermatitis evaluated in a large tertiary care pediatric center. Ann Allergy Asthma Immunol 2017; 629-647 21. Mahdavinia M, Rasmussen HE, Engen P, Van den Berg JP, Davis E, Engen K, et al. Ann Allergy Asthma Immunol. 2017 Jun;118(6):742-743 22. Emeksiz ZS , Cavkaytar O, Aksoy I, Dallar Y, Soyer O. Food Hypersensitivity in Atopic Dermatitis During Infancy: skin Prick Testing for Whom? Asthma Allergy Immunol 2017;15:32-37 23. Lack G, Fox D, Northstone K, Golding J. Factors associated with the development of peanut allergy in childhood. N Engl J Med 2003;348:977-85. 24. Fox AT, Sasieni P, du Toit G, Syed H, Lack G. Household peanut consumption as a risk factor for the development of peanut allergy. J Allergy Clin Immunol 2009;123:417-23