Prevalence and Characteristics of Accidental Ingestions Among Pediatric Food Allergy Patients

IF 8.2 1区医学 Q1 ALLERGY Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2024-11-01 DOI:10.1016/j.jaip.2024.08.006

Cynhia Hsu BS , Shweta Hosakoppal MD , Meagan Yong MS, MPH , Ruchi Gupta MD , Melanie Makhija MD , Anne Marie Singh MD

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Abstract

Background

Despite a known diagnosis of food allergy, accidental ingestions continue to occur.

Objective

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 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. In addition, chart reviews of 100 pediatric participants from Lurie Children’s Hospital of Chicago allergy clinics (typical clinical encounters) were compared with the prospective survey results.

Results

A total of 196 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 1 year. The rate of accidental ingestions reported in the prospective survey was high: 10% to 25% of participants each month reported 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 for milk, followed by sesame (20.0%) and egg (18.8%). Rates of anaphylaxis after exposure were high in 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 on allergen avoidance and accidental exposure is imperative.

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儿科食物过敏患者意外摄入食物的发生率和特点。

背景：尽管已确诊食物过敏，但意外摄入仍时有发生：我们试图描述意外摄入的特点，包括发生率、风险因素、食物过敏原诱发因素以及反应的严重程度：2015年4月至2017年4月期间，西北大学食物过敏联合会（FARC）对食物过敏儿童的父母进行了前瞻性月度调查。月度调查包括上个月经历的任何过敏反应的问题。此外，对芝加哥卢瑞儿童医院过敏门诊（典型临床会诊）的100名儿科参与者的病历回顾与前瞻性调查结果进行了比较：对 196 名 FARC 调查参与者和 100 名回顾性审查对象进行了分析。31.1%的调查对象和19.0%的回顾性研究对象报告在一年内至少发生过一次误食。前瞻性调查中报告的误食率很高：每月有 10-25% 的参与者报告误食，而且多次误食很常见。常见的诱发因素是牛奶、小麦和树坚果。在回顾性队列中，误食牛奶的比例最高（25.0%），其次是芝麻（20.0%）和鸡蛋（18.8%）。在前瞻性队列和回顾性队列中，接触后发生过敏性休克的比例都很高（分别为 33.1% 和 16.7%）：结论：食物过敏患者的意外摄入率很高。结论：食物过敏患者中意外摄入食物的比例很高，多次摄入食物（尤其是牛奶）的情况很常见。过敏性休克的发生率也很高，这表明围绕过敏原的避免和意外接触对患者进行持续教育势在必行。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Allergy and Clinical Immunology-In Practice ALLERGYIMMUNOLOGY-IMMUNOLOGY

CiteScore

11.10

自引率

9.60%

发文量

683

审稿时长

50 days

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.