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

This study was aimed to evaluate the prevalence of soy protein hypersensitivity in cow's milk protein-sensitive children in Korea. A total of 1,363 patients with atopic dermatitis, urticaria, enterocolitis syndrome, bronchial asthma or allergic rhinitis were recruited. First, we estimated the prevalence of sensitization to soy in children sensitized to cow's milk. Specific IgE levels > 0.7 kU/L by CAP assay were considered positive. Next, the prevalence of soy allergy in cow's milk allergy (CMA) patients was investigated. Those children whose parents agreed to participate the open challenge test with soy had a convincing history of allergic reactions elicited by cow's milk and these symptoms were relieved by elimination. All of them had negative soy-specific IgE. Patients with positive soy-specific IgE accounted for 18.3% of 224 children sensitized to cow's milk protein. The prevalence of sensitization to soy decreased with age (36.8% in the first year of life, 16.4% in the second year, and 13.7% in the third year). Of 21 CMA patients, 42.9% (n=9) were determined to have soy allergy (mean age 10.3 months). Our results suggest that soy protein formula should be carefully used as a substitute for cow's milk in CMA patients, especially during infancy.
Adolescent ; Age Factors ; Allergens ; Asthma/immunology ; Child ; Child, Preschool ; Dermatitis, Atopic/immunology ; Enterocolitis/immunology ; Female ; Food Hypersensitivity/*epidemiology/immunology ; Human ; Hypersensitivity ; Immunoglobulin E/blood/metabolism ; Infant ; Korea ; Male ; Milk Hypersensitivity/*epidemiology/immunology ; Prevalence ; Rhinitis/immunology ; Soybean Proteins/*chemistry ; Urticaria/immunology

Animals ; China ; epidemiology ; Clinical Trials as Topic ; Evidence-Based Medicine ; Humans ; Infant ; Infant, Newborn ; Milk Hypersensitivity ; diagnosis ; epidemiology ; therapy ; Milk Proteins ; adverse effects ; immunology ; Practice Guidelines as Topic ; standards ; Skin Tests ; methods