Food Sensitization and Food Allergy in Atopic Dermatitis

Year 2019, Volume: 41 Issue: 4, 405 - 412, 01.10.2019

Burçin Beken , Velat Çelik , Pınar Gökmirza Özdemir Necdet Süt Mehtap Yazıcıoğlu

https://doi.org/10.20515/otd.490646

Abstract

Atopic dermatitis
is the most common chronic inflammatory skin disease of childhood and foods are
among the factors that exacerbate eczema. In this study, we aimed to
investigate the frequency of food sensitization and food allergies in atopic
dermatitis and their association with diseaseseverity. The data of 236 patients
aged between 0 -18 years who were diagnosed as atopic dermatitis between
2015-2018 at our Pediatric Allergy and Immunology Department were
retrospectively examined. The food sensitization was positive in 68 (31%)
patients and the most sensitized foods were egg (20%), cow’s milk (11.8 %) and
peanut (4.5%). A total of 147 oral food challenges were performed on 133
patients and 41 (30.8%) patients were diagnosed as food allergy (36 (27%) milk,
4 (3%) egg, 1 (0.8%) pumpkin seed). 
Patients were divided into two groups according to disease severity as
mild (Group 1) and moderate-severe (Group 2) atopic dermatitis. There were no
differences between the groups in terms of age of onset, gender, parental atopy,
IgE level, eosinophil count and inhalan allergen sensitization. Food
sensitization and food allergy were respectively 20%, 8% in group 1 and 34%,
21% in group 2. Both food sensitization and food allergy were significantly
higher in group 2 (p=0.039, p= 0.041, respectively). Approximately one third of
patients with atopic dermatitis are accompanied by food allergies and
moderate-severe atopic dermatitis comprises higher risk. Food allergy diagnosis
should be confirmed by oral food challenges, which is the gold standard
diagnostic test and unnecessary food eliminations should be avoided.

Keywords

atopic dematitis, food allergy

Atopik Dermatitte Besin Duyarlanması ve Besin Alerjisi

Abstract

Atopik dermatit
çocukluk çağının en sık görülen kronik inflamatuar cilt hastalığı olup,
besinler egzemayı alevlendiren faktörler arasında yerini almaktadır. Bu
çalışmada atopik dermatitli hastalarda besin duyarlanması ve besin alerjisi
sıklığını araştırmak ve bunların atopik dermatit şiddeti ile ilişkisinin
incelenmesi amaçlanmıştır. Üniversitemiz Çocuk İmmunolojisi ve Alerji
Hastalıkları Bilim Dalı’nda2015-2018 yılları arasında atopik dermatit tanısı
konulan 0-18 yaş arasındaki 236 hastanın verileri sonuçları retrospektif olarak
incelendi. Besin alerjen duyarlanması68 (%31) hastada pozitif olup duyarlanma
saptanan ilk üç besin sırasıyla yumurta (%20), inek sütü (%11,8) ve yer fıstığı
(%4,5) idi. Yüz otuz üç hastaya toplam 147 besin yükleme testi yapıldı. Besin yükleme
testi ile 36 (%27) hastada inek sütü, 4 (%3) hastada yumurta alerjisi
gösterildi. Kabak çekirdeği ile anafilaksi öyküsü ve deri prik testi
pozitifliği olan 1 (%0,8) hasta ile birlikte toplam 41 (% 30,8) hastada besin
alerjisi tanısı konuldu. Hastalar hastalık şiddetine göre hafif (grup 1) ve
orta-ağır(grup 2) şiddette atopik dermatit olarak iki gruba ayrılarak
karşılaştırıldığında; şikayet başlangıç yaşı, cinsiyet, ailede atopi öyküsü,
IgE düzeyi, eozinofil sayısı ve inhalan alerjen duyarlanması açısından iki grup
arasında fark saptanmadı.  Besin alerjen
duyarlanması ve besin alerjisi grup 1’de sırasıyla %20, %8; grup 2’de %34, %21
olup, grup 2’de anlamlı olarak yüksek saptandı (sırasıyla p=0.039, p= 0.041).  Atopik dermatitli hastaların yaklaşık üçte birinde
besin alerjisi eşlik etmektedir. Özellikle orta-ağır atopik dermatitli hastalar
bu açıdan riskli gruptadır. Besin alerjisi tanısı altın standart tanı testi
olan besin yükleme testi ile doğrulanmalı, gereksiz besin eliminasyonundan
kaçınılmalıdır

Keywords

atopik dermatit, besin alerjisi, çocuk

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