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Evaluation of Frequency of the Food Allergy to wheat Flour, Cow’s Milk, Eggs, Soya and Peanuts in 240 Patients with Atopic Eczema Older than 14 Years


Authors: J. Čelakovská 1;  K. Ettlerová 2;  K. Ettler 1;  J. Vaněčková 1;  J. Bukač 3
Authors‘ workplace: Klinika nemocí kožních a pohlavních FN a LF UK Hradec Králové přednosta doc. MUDr. Karel Ettler, CSc. 1;  Ambulance klinické imunologie a alergologie, Hradec Králové vedoucí MUDr. Květuše Ettlerová 2;  Ústav lékařské biofyziky LF UK Hradec Králové, přednosta doc. Ing. Josef Hanuš, CSc. 3
Published in: Čes-slov Derm, 88, 2013, No. 5, p. 214-222
Category: Clinical and laboratory Research

Overview

Our aim was the evaluation of food allergy to egg’s white and yolk, peanuts, soya, cow’s milk and wheat and follow up of patients with confirmed food allergy. The study included 240 patients with atopic dermatitis (70 men, 170 women, average age was 26.4 from the age of 14 to 63 years, with the median SCORAD 31 points at the beginning of the study). Complete dermatological and allergological examination was performed, including specific IgE, atopy patch tests and skin prick tests. In patients with positive results the diagnostic hypoallergenic diet was introduced and challenge test was performed with suspected food. In patients suffering from moderate or severe form of atopic dermatitis the exposure test with cow milk and wheat flour was performed even if laboratory tests were negative. The positivite tests (including challenge tests) were recorded altogether in 143 patients (60%). From them the food allergy was confirmed in 65 patients (27.5%) and the sensitisation was recorded in 78 patients (32.5%). Allergy to peanuts was confirmed in 20%, to egg in 6%, to soya in 3%, to wheat in 2.5% and to milk in 0.8% of patients. The most common symptom was oral allergy syndrome in 17% of patients after ingestion of peanuts. The worsening of atopic dermatitis was recorded in 7% of patients after ingestion of egg, wheat and soya. The course of atopic dermatitis showed a positive trend at 3, 6 and 12 months of follow-up after avoiding the offending allergen. We conclude that the diagnostic work-up of food allergy in patients suffering from atopic dermatitis should comprise not only the laboratory methods, but as well the diagnostic hypoallergenic diet and the challenge test.

Key words:
atopic dermatitis – food allergy – specific IgE – atopy patch tests – skin prick tests – challenge tests


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