Publication:
Proven food-induced acute urticaria and predictive factors for definitive diagnosis in childhood

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2021-02-18

Authors

Aydoğan, Metin
Topal, Erdem
Uysal, Pınar
Acar, Hazal Cansu
Cavkaytar, Özlem
Demirkale, Zeynep Hızlı
Aydoğmuş, Çiğdem
Yakıcı, Nalan
Aydemir, Sezin
Akkelle, Emre

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Karger

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Abstract

Background: Urticaria can be the only sign of a food allergy or can be seen together with other signs and symptoms of a food allergy. Objective: To determine the demographic, etiologic, and clinical features of food-induced acute urticaria in childhood. Methods: Patients suspected of food-induced acute urticaria were included in this prospective cross-sectional multicenter study. Results: Two hundred twenty-nine urticaria cases were included in this study. Seventeen patients who did not meet the inclusion criteria of the study were excluded. Of the 212 included cases, 179 (84.4%) were diagnosed with definitive food-induced acute urticaria. The most common foods causing acute urticaria were cow's milk, hen's eggs, and nuts in 56.4, 35.2, and 19% of cases, respectively. The positive predictive value of a history of milk-induced acute urticaria together with a milk-specific IgE >5 kU/L for cow's milk-induced acute urticaria was 92% (95% CI: 81-96%). A history of cow's milk-induced and/or hen's egg-induced acute urticaria was consistent with a definitive diagnosis of food-induced urticaria (Chen's kappa: 0.664 and 0.627 for milk and eggs, respectively). Urticaria activity scores were higher in patients with food-induced acute urticaria (p = 0.002). Conclusion: Cow's milk, hen's eggs, and nuts were the most common allergens in the etiology of childhood food-induced acute urticaria. Although the urticaria activity score provides guidance for diagnosis, an oral food challenge is often essential for the definitive diagnosis of a patient with a history of food-induced acute urticaria.

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Allergy, Ige, Anaphylaxis, Challenge, Epidemiology, Progression, Guidelines, Management, Children, Childhood, Food allergy, Urticaria, Allergy, Immunology

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