Oral immunotherapy for multiple foods in a pediatric allergy clinic setting
| Autor: | Jaweriah S. Siddiqui, William J. Lavery, Amy Eapen, Michelle B. Lierl |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Allergy Adolescent medicine.medical_treatment Immunology Administration Oral Article 03 medical and health sciences 0302 clinical medicine Food allergy Internal medicine Allergy test medicine Humans Immunology and Allergy 030212 general & internal medicine Dosing Child Contraindication Skin Tests Desensitization (medicine) business.industry Incidence (epidemiology) Medical record digestive oral and skin physiology Infant Allergens Immunoglobulin E medicine.disease 030228 respiratory system Desensitization Immunologic Child Preschool Female Emergency Service Hospital business Food Hypersensitivity |
| Zdroj: | Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology |
| ISSN: | 1081-1206 |
| DOI: | 10.1016/j.anai.2019.08.463 |
| Popis: | Background The increasing incidence of pediatric food allergy results in significant health care burden and family stress. Oral immunotherapy (OIT) can induce tolerance to peanut, milk, and egg. OIT for other foods, particularly multiple foods simultaneously, has not been thoroughly studied. Objective To summarize our experience with OIT for multiple foods in a pediatric allergy clinic setting. Methods Medical records were reviewed for patients undergoing OIT for multiple foods. Methods and outcomes of OIT were summarized. Outcomes were analyzed for correlation with baseline food allergen skin prick tests (SPTs) and specific IgE (sIgE) test results. Results Forty-five patients aged 1.5 to 18 years undertook OIT for up to 12 foods, including peanut, tree nuts, seeds, legumes, and egg. At the time of review, 35 patients were receiving daily maintenance dosing, 4 had completed OIT and were continuing to eat their foods 3 times weekly, and 6 had stopped OIT because of anxiety, inconvenience, or allergy symptoms. A total of 49% of patients had reactions during the up-dosing process, mostly oral itching (33%), perioral hives (40%), and abdominal pain (35%). There was no correlation of baseline skin prick test (SPT) and sIgE test results with reaction threshold for baseline food challenge, lowest dose causing reactions during up-dosing, or time to reach maintenance. Higher baseline sIgE level but not baseline SPT result was associated with an increased number of allergic reactions during OIT. Baseline SPT correlated with stopping OIT. Conclusion A similar approach to that used for peanut OIT can be taken for nonpeanut foods and for multiple foods simultaneously. High baseline allergy test results are not a contraindication to OIT. |
| Databáze: | OpenAIRE |
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