Atopic dermatitis (AD) is a chronic, relapsing, inflammatory skin disease. Children with AD tend to have a higher prevalence of food allergies. This study investigated the clinical significance of food sensitization in AD patients. A total of 266 AD patients participated in this study. The prevalence of food sensitization and clinically relevant sensitization were compared in the subjects according to their age and AD severity. Sera from all patients were analyzed for food-specific IgE levels using the Pharmacia CAP System FEIA. The serum specific IgE levels for egg, milk, peanut and soybean were measured. Patients were regarded as sensitized to the food if their food-specific IgE levels were above 0.35 kUA/L. Also the food-specific IgE levels, the so-called diagnostic decision point, which is recommended as the clinically relevant level, for clinical food allergy, as suggested by Sampson et al, was used as an alternative method. From the measurement of food-specific IgE antibodies of the four foods, egg was the most highly sensitized and the main causative allergenic food in children with AD. The positive rates of specific IgE to the four major food allergens, and the prevalences of clinically relevant food sensitization, were higher for all foods tested in the group less than 1 year of age, and were significantly higher in moderate to severe AD compared to mild AD in infants and young children. In summary, presence of food specific IgE is prevalent in infants and young children with AD, and clinically relevant food sensitization is important in Korean infants and children with moderate to severe AD.
Child, Preschool ; Dermatitis, Atopic/*immunology ; Egg Hypersensitivity/epidemiology ; Female ; Food Hypersensitivity/diagnosis/*epidemiology ; Humans ; Immunoglobulin E/blood ; Infant ; Male ; Milk Hypersensitivity/epidemiology ; Peanut Hypersensitivity/epidemiology ; Soybeans/immunology

With the exception of shellfish, the overall food allergy rates in Singapore have not reached the epidemic proportions of the West. The rates of egg, milk and fish allergies remain low. However, the patterns of some food allergies in Singapore have changed over the last decade. For example, peanut allergy, once rare in Singapore, is now the most common cause of anaphylaxis in children. Studies analysing lifestyle practices, particularly with respect to prevention of food allergy, are necessary in order for practitioners to understand global differences and maintain this low prevalence.
Anaphylaxis ; diagnosis ; Child ; Child, Preschool ; Egg Hypersensitivity ; Fish Products ; Food Hypersensitivity ; diagnosis ; epidemiology ; prevention & control ; Humans ; Infant ; Infant, Newborn ; Milk Hypersensitivity ; Peanut Hypersensitivity ; Singapore ; epidemiology ; Surveys and Questionnaires

Food allergy has emerged as an important public health problem affecting people of all ages in many countries. The prevalence varies according to age, geographic regions, and ethnicity. For several years, many studies have suggested that the prevalence of food allergy is increasing at an alarming rate, for unclear reasons. Conversely, some studies have also provided findings that sensitization to common food allergens did not increase. Increased recognition rather than an actual increase in patients with IgE-mediated food allergy might lead to the increases in the prevalence of self-reported or physician-diagnosed food allergy. It is also noted that the prevalence of food allergy differs even in the same region according to the study design, i.e., hospital-based or community-based studies. Despite these limitations, epidemiologic data are important because they provide useful information on diagnosis, treatment, and prevention of food allergy. This review focuses on advances in the epidemiology of food allergy in Korean children.
Allergens ; Child ; Diagnosis ; Epidemiology ; Food Hypersensitivity ; Humans ; Prevalence ; Public Health

In Korea, there are two descrite pollen seasons: a tree pollen season and a weed pollen season. In order to investigate the incidence of sensitization to the major pollens and to evaluate is clinical significance in respriatory allergic disease, skin prick tests were performed using 7 species of Korean pollen extracts (K-P extracts) and specific IgE was measured by the Phadebas radioallergosorbent test (RAST) in patients with positive skin prick tests. Of the 317 patients with respiratory allergic diseases 73 patients (23.0%) were skin prick test positive to one or more K-P extracts and the positive reactions to individual pollens were as follows: 14.2% (45/317) positive to sagebrush 10.4% to ragweed, 5.0% to grass, 4.1% to oak, 3.8% to alder, 1.9% to poplar; and 0% to pine. The 30-39yr old group manifested the highest skin test positivity 36.7%. There was no difference in the skin reactivity according to the patient's sex and the kinds of allergic disease. Also there was no relationship between birth season and skin test positivity. The agreement between the results of the skin prick test with K-P and commercially prepared Bencard's pollen extracts (B-P extracts) was good. There were good correlations between the strongly positive skin prick test and a posivite RAST and also between a netative skin prick test and a negative RAST. From this study, it can be concluded that overall sensitization rate of respiratory allergy patients to K-P exstracts was 23.0%, and that weed pollens such as sagebrush and ragweed were major pollens.
Female ; Human ; Korea ; Male ; Pollen/adverse effects* ; Radioallergosorbent Test ; Respiratory Hypersensitivity/diagnosis ; Respiratory Hypersensitivity/epidemiology* ; Skin Tests

Allergy skin prick test and intradermal test represent one of the major tools in the diagnosis of IgE- mediated diseases like as atopic asthma, allergic rhinitis, atopic dermatitis, food and drug allergy, and insect bite when properly performed. Skin tests are of particular importance in fields such as allergen standardization, pharmacology, and epidemiology. Even if skin tests seem easy to perform, adequate and proper interpretation requires well-trained physicians who can recognize the numerous factors that may modify the results of skin tests.
Asthma ; Dermatitis, Atopic ; Diagnosis ; Drug Hypersensitivity ; Epidemiology ; Hypersensitivity ; Insect Bites and Stings ; Intradermal Tests ; Pharmacology ; Rhinitis ; Skin Tests* ; Skin*

BACKGROUND: Prevalence of food allergy is increasing all over the world including in Asia. Diagnosis of food allergy in Asia is usually made after family complaints or by elimination and/or reintroduction foods. This could lead to an inaccurate diagnosis and to incorrect information on epidemiology of food allergy. We, herein, reported results of a 16-year experience (1996–2012) of oral food challenge (OFC) performed in pediatric patients at a major teaching hospital in Thailand. OBJECTIVE: The major objectives of this report are to review types of foods selected for oral challenges, frequency of positive/negative challenges to these foods and the clinical reactions during challenges among these children. METHODS: Medical records of 206 children underwent OFC between 1996 and 2012 for various indications at the Allergy clinic of Pediatric Department, Siriraj Hospital, Mahidol University (age range, 4 months to 17 years) were retrospectively reviewed. Data including clinical data, skin prick test results and specific IgE levels were analyzed with respect to challenge results (positive/negative). During the period of the study, 2 separate investigations on shrimp allergy and wheat allergy were conducted. RESULTS: Sixty of 206 children (29%) had positive OFC, whereas 84 out of 306 OFC (27.5%) were positive. The most common food giving positive challenges in this study was shrimp (40%). Among children less than 3 years of age, the most common food with positive challenge was wheat (70%) whereas among children 3 years of age or older, shellfish was the most common food (42%). Cutaneous reactions were the most common reactions observed. CONCLUSION: Only 1 of 3 of children underwent OFC in this study had positive challenges. Shrimp was the most common food causing challenge in this study especially among children older than 3 year of age. Wheat has become another leading food besides cow's milk and egg in causing positive OFC in younger children in Thailand.
Asia ; Child ; Diagnosis ; Epidemiology ; Food Hypersensitivity ; Hospitals, Teaching ; Humans ; Hypersensitivity ; Immunoglobulin E ; Medical Records ; Milk ; Ovum ; Prevalence ; Retrospective Studies ; Shellfish ; Skin ; Thailand ; Triticum ; Wheat Hypersensitivity

The prevalence and patterns of food allergy are highly variable in different parts of the world. Differences in food allergy epidemiology may be attributed to a complex interplay of genetic, epigenetic, and environmental factors, suggesting that mechanisms of food allergy may differ in various global populations. Genetic polymorphisms, migration, climate, and infant feeding practices all modulate food allergy risk, and possibly also the efficacy of interventions aimed at primary prevention of food allergy development. Approaches to diagnosis, treatment, and prevention of food allergy should thus be tailored carefully to each population's unique genetic and environmental make-up. Future research in the context of food allergy prevention should focus on elucidating factors determining differential responses between populations.
Climate ; Dermatitis, Atopic ; Diagnosis ; Epidemiology ; Epigenomics ; Food Hypersensitivity* ; Genetics ; Humans ; Infant ; Polymorphism, Genetic ; Prevalence ; Primary Prevention

OBJECTIVEFood allergy as one of social health problems has gained more attention of people. However, few reports on prognosis of food allergy, the relation between infant food allergy and other allergic diseases, and factors affecting prognoses of infant food allergy in China. The present study was designed to investigate the evolution of infancy food allergy and to explore predicting factors of the tolerance to these foods and factors of other allergic diseases to provide a clue for managing children with food allergy reasonably and to improve their prognoses.

METHODSTotally 119 children with food allergy during infancy, who were diagnosed in the Department of Primary Child Care, Children's Hospital, Chongqing University of Medical Sciences from January 2000 to June 2003, were studied retrospectively by analyzing the follow-up data before March 2004. The occurrence of food tolerance and other allergic diseases were counted. Kaplan-Meier methods were used to calculate the cumulative tolerance probability. And the predicting factors of persistent food allergy and influential factors of other allergic diseases were analyzed by unconditional Logistic regression models.

RESULTSThe cumulative tolerance probabilities of cow's milk and egg were 42% and 31% one year after diagnosis respectively, 63% and 62% 2 years later, 77% and 80% 3 years later, and 100% after 4 years. And the severity of skin prick test reactions to cow's milk and egg was the predicting factor for persisting hypersensitivity to cow's milk and egg (OR = 2.535, 95% CI: 1.159-5.543; OR = 2.654, 95% CI: 1.302-5.410, P < 0.05). Thirteen cases presented with hypersensitivity to other foods (15.6 +/- 6.1) months after the diagnosis was confirmed, and the risk factor was the long-lasting hypersensitivity to egg (OR = 6.109, 95% CI: 1.818-20.527, P < 0.05). After 4 cases and 15 cases were diagnosed as allergic rhinitis and asthma, respectively, (16.8 +/- 8.3) months after diagnoses and the risk factors were the long-lasting hypersensitivity to egg and the respiratory symptoms (OR = 3.596, 95% CI: 1.429-9.045; OR = 4.235, 95% CI: 1.152-15.563, P < 0.05).

CONCLUSIONAt least 75% of children with egg or cow's milk allergy could develop tolerance to egg or cow's milk within 3 years after diagnoses; 10.9%, 12.6% and 3.4% of children with food allergy suffered from other food allergy, asthma and allergic rhinitis. Strengthening the screening and management of children at high risk for persistent food allergy will contribute to improvement of the prognoses of food allergy.

Child, Preschool ; China ; epidemiology ; Female ; Food Hypersensitivity ; diagnosis ; epidemiology ; immunology ; Humans ; Immune Tolerance ; Infant ; Male ; Prognosis ; Retrospective Studies ; Risk Factors

Scombroid fish poisoning (SFP) is a form of histamine food poisoning caused by the ingestion of improperly stored fish. The term “scombroid” derives from the family name of the fish family first implicated, such as tuna and mackerel. On the other hand, non-scombroid fish species, such as sardine and herring, can also cause histamine poisoning. The histamine is converted from histidine by a bacterial enzyme in the causative fish. Because the symptoms of SFP can easily be confused with food allergies, it is believed to have been significantly under-reported. In 2016, an outbreak of SFP occurred among primary school students who had eaten yellowtail steak in Korea. The most common findings consisted of a rapid onset of flushing of the face and trunk, erythematous and urticarial rash, diarrhea, and headache occurring soon after consuming the spoiled fish. Usually, the course is self-limiting and antihistamines can be used successfully to relieve symptoms, but several life-threatening SFP cases have been reported. Clinical toxicologists should be familiar with SFP and have competency to make a differential diagnosis between fish allergy and histamine poisoning. SFP is a histamine-induced reaction caused by the ingestion of histamine-contaminated fish, whereas a fish allergy is an IgE-mediated reaction. This review discusses the epidemiology, pathophysiology, diagnosis, treatment, and preventive measures of SFP.
Diagnosis ; Diagnosis, Differential ; Diarrhea ; Eating ; Epidemiology ; Exanthema ; Flushing ; Food Hypersensitivity ; Foodborne Diseases ; Hand ; Headache ; Histamine Antagonists ; Histamine ; Histidine ; Humans ; Hypersensitivity ; Korea ; Perciformes ; Poisoning ; Tuna

Previous studies suggest that maternal characteristics may be associated with neonatal outcomes. However, the influence of maternal characteristics on birth weight (BW) has not been adequately determined in Korean populations. We investigated associations between maternal characteristics and BW in a sample of 813 Korean women living in the Seoul metropolitan area, Korea recruited using data from the prospective hospital-based COhort for Childhood Origin of Asthma and allergic diseases (COCOA) between 2007 and 2011. The mean maternal age at delivery was 32.3 +/- 3.5 yr and prepregnancy maternal body mass index (BMI) was 20.7 +/- 2.5 kg/m2. The mean BW of infant was 3,196 +/- 406 g. The overall prevalence of a maternal history of allergic disease was 32.9% and the overall prevalence of allergic symptoms was 65.1%. In multivariate regression models, prepregnancy maternal BMI and gestational age at delivery were positively and a maternal history of allergic disease and nulliparity were negatively associated with BW (all P < 0.05). Presence of allergic symptoms in the mother was not associated with BW. In conclusion, prepregnancy maternal BMI, gestational age at delivery, a maternal history of allergic disease, and nulliparity may be associated with BW, respectively.
Adult ; *Birth Weight ; Body Mass Index ; Cohort Studies ; Female ; Gestational Age ; Humans ; Hypersensitivity/diagnosis/epidemiology ; Infant, Newborn ; Linear Models ; Male ; *Mothers ; Parity ; Pregnancy ; Republic of Korea/epidemiology