Cynhia Hsu, Shweta Hosakoppal, Meagan Yong, Ruchi Gupta, Melanie Makhija, Anne Marie Singh
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Abstract
Background: Despite a known diagnosis of food allergy, accidental ingestions continue to occur.
Objectives: We sought to characterize accidental ingestions, including prevalence, risk factors, food allergen triggers, and severity of reactions.
Methods: A prospective monthly survey developed by the Food Allergy Consortium (FARC) at Northwestern University was administered to parents of food allergic children between April 2015 and April 2017. The monthly survey included questions on any allergic reactions experienced in the previous month. Additionally, chart review of 100 pediatric participants from Lurie Children's Hospital of Chicago allergy clinics (typical clinical encounters) were compared to the prospective survey results.
Results: 196 FARC survey participants and 100 retrospective review subjects were analyzed. 31.1% of participants from the surveyed cohort and 19.0% of participants from the retrospective review reported at least 1 accidental ingestion over one year. The rate of accidental ingestions reported in the prospective survey was high: 10-25% of participants each month report an accidental ingestion, and multiple ingestions were common. Common triggers were milk, wheat, and tree nuts. In the retrospective cohort, the highest rate of accidental ingestion (25.0%) occurred to milk, followed by sesame (20.0%) and egg (18.8%). Rates of anaphylaxis after exposure were high among both the prospective and retrospective cohorts (33.1% and 16.7% respectively).
Conclusions: Accidental ingestion rates were high among food allergic patients. Multiple exposures, especially to milk, were common. Incidence of anaphylaxis was also high, suggesting that ongoing patient education around allergen avoidance and accidental exposure is imperative.
期刊介绍：
JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases.
This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders.
The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.
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