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Allergy To Shrimp: A Double Blind, Placebo-controlled, Food Challenge Study And Allergens Implicated In Spain.
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Aeroallergens As Risk And Outcome Factors In Pre-school And Breast-fed Children D. Antolin-Amerigo, M. Zamorano-Serrano, M. Terrados-Cepeda, J. Gonzalez-Cervera, P. Berges-Gimeno, C. Vidal-Albareda, J. Sola-Martinez, E. Alvarez-Cuesta; Allergy Department. Hospital Ramon y Cajal, Madrid, Spain. RATIONALE: It’s thought that aeroallergen sensitization is infrequent in pre-school and breast-fed children. We expect to find out the frequency and type of allergen sensitization in children under the age of five. METHODS: 250 medical histories of children under the age of five who were derived from primary care centers located in our healthcare area with suspicion of asthma were reviewed, selecting 174 with asthma. We used SPSS version 12 to create a database and analyse the impact in asthma of several variables: age, date of consultation and birth, atopic dermatitis, food allergy, asthma severity, type of sensitization, and celiac disease. RESULTS: 41% of the entire children studied had aeroallergen sensitization. 39% of those who suffered from mild intermittent asthma had at least one positive aeroallergen. 51% of mild persistent asthma children were sensitized. 37% of moderate persistent asthma was explained by aeroallergens. 17% of the population sensitized had egg allergy. 10% showed present or overcame milk allergy. One important finding is that 22% of children showed atopic dermatitis and asthma due to aeroallergens compared to 21% of children under the age of five who had a history of atopic dermatitis but no aeroallergen sensitization. We observed no aeroallergen sensitization under 12 months of age. CONCLUSIONS: Precocious neumoallergen sensitization in breast-fed and pre-school children suffering from asthma is frequent in our healthcare area currently. Therefore, allergologic study is suitable.
73
SPT Is Superior To IgE CAPRAST For The Diagnosis Of Infantile Food Allergy M. Ebisawa, M. Ogata, C. Sugizaki, T. Komata, K. Ikematsu, T. Imai, H. Tachimoto; Sagamihara National Hospital, Kanagawa, Japan. OBJECTIVE: We investigated the usefulness of skin prick test (SPT) for the diagnosis of food allergy among egg white (EW)- or cow’s milk (CM)IgE CAPRAST negative infants. SUBJECTS AND METHODS: Among 202 infantile cases, who had received SPT from 2001 to 2005, 89 suspected-hen’s egg (HE) allergy and 125 suspected-CM allergy infants with negative IgE at the time of first visit were recruited to the study. EW- and CM-specific CAPRAST were later checked in 78 cases and 111 cases, respectively. RESULTS: Among 89 suspected-HE allergies with negative IgE CAPRAST, 72 infants were diagnosed as HE allergy by the elimination and provocation tests Interestingly 39 infants showed positive SPT against EW. Among 125 suspected-CM allergy infants with negative IgE, 42 cases were diagnosed as CM allergy, and 21 infants showed positive SPT against CM. In the follow up study of 78 negative EW-CAPRAST cases, 47 EWCAPRAST out of 65 egg-allergy cases turned positive later. EWCAPRAST of 7 cases in 13 non-HE allergies also turned positive, however EW-CAPRAST titer was relatively lower compared to that of egg allergies. In CM allergy, IgE CAPRAST of 21 cases turned positive among 39 CM allergy cases. CONCLUSIONS: SPT seemed to be more useful than EW- or CM- IgE CAPRAST for the diagnosis of HE or CM allergies in early infantile period, and provocation test would be required for the definitive diagnosis for suspected-HE or CM allergy infants without any proof of IgE sensitization.
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Allergy To Shrimp: A Double Blind, Placebo-controlled, Food Challenge Study And Allergens Implicated In Spain. S. Sanchez-Garcia1, C. Gamez2, E. Lopez2, M. D. Iban˜ez3, C. Escudero3, M. F. Madero1, M. T. Laso3, V. del Pozo2, J. Sastre1; 1Service of Allergy. Fundacion Jimenez Diaz, Madrid, Spain, 2Service of Immunology. Fundacion Jimenez Diaz, Madrid, Spain, 3Service of Pediatrics Allergy. Hospital Infantil Universitario del Nin˜o Jesus., Madrid, Spain. RATIONALE: Our study aimed to investigate clinical characteristics and allergens recognized by patients with suspected shrimp allergy. METHODS: We studied 35 patients with suspected allergic reactions to shrimp, mostly urticaria. In all patients double-blind placebo controlled oral challenge (DBPCOC) was performed. Prick-by-prick tests and serum specific IgE (CAP system) with mites, anisakis, mosquito, cockroach, shrimp, clam, snail, mussel, scallop, cockle, squid, octopus and cuttlefish were performed as well as IgE to rPen a1 (tropomyosin). All patient’s sera were tested individually by IgE immunodetection after SDS-PAGE with shrimp crude extract. Seven patients sensitized to mites and with good tolerance to shrimp were included as controls. RESULTS: 20 (57%) patients were considered allergic (14 1 DBPCOC and 6 anaphylaxis). Specific IgE was positive to all of extracts tested by CAP, except in 2 patients. 17 were sensitized to mites. All but 2 had specific IgE to tropomyosin, in 1 only detected by immunoblotting. In patients with negative DBPCOC, 5 had specific IgE to other seafood and 10 to mites. In the control group all CAP determinations were negative except in one patient who had specific IgE to shrimp and other patient a 37 kDa IgE-binding band. Immunoblots demonstrated several IgE bindingbands. The main bands were of 37 and 20 kDa in 12 allergic patients. These bands were also detected in 3 patients with negative DBPCOC. CONCLUSIONS: This study shows the need to perform food challenges for a correct diagnosis. Tropomyosin seems the major allergen in shrimp allergic patients in Spain, although, other allergens may be implicated.
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Correlation Of Oral Allergy Syndrome Due To Plant-derived Foods With Pollens In Japan N. Maeda, N. Inomata, A. Morita, M. Kirino, Z. Ikezawa; Yokohama City University Hosipital, Yokohama, Japan. RATIONALE: The clinical features of patients with oral allergy syndrome (OAS) due to plant-derived foods have been rarely reported in Japan. We investigated whether pollen sensitizations would be correlated with prevalence of OAS. METHODS: We measured specific IgE antibodies (ImmunoCAP: CAP) against Japanese cedar, alder, orchard grass, ragweed, and mugwort in 622 outpatients (M: F 5 277:345, mean age, 37 years) with skin allergy over a two-year period.We statistically analyzed whether there was any correlation between prevalence of OAS and sensitization to the pollens. RESULTS: Prevalence of OAS is 2.3% in outpatients with skin allergy. Ratios of positive response to CAP against Japanese cedar, alder, orchard grass, ragweed, and mugwort were 69.8%, 24.1%, 29.1%, and 35.3%, respectively. Prevalence of OAS showed a significant positive correlation (p < 0.001) with sensitization to alder, but no correlation with sensitization to Japanese cedar, orchard grass, ragweed, and mugwort. The most frequent causative foods were found to be apple, peach, melon, and kiwi. Prevalence of OAS due to apple showed a significant positive correlation (p < 0.001) with sensitization to alder. Prevalence of OAS due to peach showed a significant positive correlation (p < 0.001 and p < 0.05) with sensitization to alder and orchard grass. Further, prevalence of OAS due to melon showed a significant positive correlation (p < 0.005, p < 0.05 and p < 0.05) with sensitization to alder, orchard grass, and ragweed. CONCLUSIONS: In this study, it was suggested that the sensitization to the pollens from species belonging to Betulaceae family would be most strongly involved in prevalence of OAS in Japan as same as in Northern and Center Europe.
SATURDAY
Abstracts S23
J ALLERGY CLIN IMMUNOL VOLUME 123, NUMBER 2
Aeroallergens As Risk And Outcome Factors In Pre-school And Breast-fed Children D. Antolin-Amerigo, M. Zamorano-Serrano, M. Terrados-Cepeda, J. Gonzalez-Cervera, P. Berges-Gimeno, C. Vidal-Albareda, J. Sola-Martinez, E. Alvarez-Cuesta; Allergy Department. Hospital Ramon y Cajal, Madrid, Spain. RATIONALE: It’s thought that aeroallergen sensitization is infrequent in pre-school and breast-fed children. We expect to find out the frequency and type of allergen sensitization in children under the age of five. METHODS: 250 medical histories of children under the age of five who were derived from primary care centers located in our healthcare area with suspicion of asthma were reviewed, selecting 174 with asthma. We used SPSS version 12 to create a database and analyse the impact in asthma of several variables: age, date of consultation and birth, atopic dermatitis, food allergy, asthma severity, type of sensitization, and celiac disease. RESULTS: 41% of the entire children studied had aeroallergen sensitization. 39% of those who suffered from mild intermittent asthma had at least one positive aeroallergen. 51% of mild persistent asthma children were sensitized. 37% of moderate persistent asthma was explained by aeroallergens. 17% of the population sensitized had egg allergy. 10% showed present or overcame milk allergy. One important finding is that 22% of children showed atopic dermatitis and asthma due to aeroallergens compared to 21% of children under the age of five who had a history of atopic dermatitis but no aeroallergen sensitization. We observed no aeroallergen sensitization under 12 months of age. CONCLUSIONS: Precocious neumoallergen sensitization in breast-fed and pre-school children suffering from asthma is frequent in our healthcare area currently. Therefore, allergologic study is suitable.
73
SPT Is Superior To IgE CAPRAST For The Diagnosis Of Infantile Food Allergy M. Ebisawa, M. Ogata, C. Sugizaki, T. Komata, K. Ikematsu, T. Imai, H. Tachimoto; Sagamihara National Hospital, Kanagawa, Japan. OBJECTIVE: We investigated the usefulness of skin prick test (SPT) for the diagnosis of food allergy among egg white (EW)- or cow’s milk (CM)IgE CAPRAST negative infants. SUBJECTS AND METHODS: Among 202 infantile cases, who had received SPT from 2001 to 2005, 89 suspected-hen’s egg (HE) allergy and 125 suspected-CM allergy infants with negative IgE at the time of first visit were recruited to the study. EW- and CM-specific CAPRAST were later checked in 78 cases and 111 cases, respectively. RESULTS: Among 89 suspected-HE allergies with negative IgE CAPRAST, 72 infants were diagnosed as HE allergy by the elimination and provocation tests Interestingly 39 infants showed positive SPT against EW. Among 125 suspected-CM allergy infants with negative IgE, 42 cases were diagnosed as CM allergy, and 21 infants showed positive SPT against CM. In the follow up study of 78 negative EW-CAPRAST cases, 47 EWCAPRAST out of 65 egg-allergy cases turned positive later. EWCAPRAST of 7 cases in 13 non-HE allergies also turned positive, however EW-CAPRAST titer was relatively lower compared to that of egg allergies. In CM allergy, IgE CAPRAST of 21 cases turned positive among 39 CM allergy cases. CONCLUSIONS: SPT seemed to be more useful than EW- or CM- IgE CAPRAST for the diagnosis of HE or CM allergies in early infantile period, and provocation test would be required for the definitive diagnosis for suspected-HE or CM allergy infants without any proof of IgE sensitization.
74
Allergy To Shrimp: A Double Blind, Placebo-controlled, Food Challenge Study And Allergens Implicated In Spain. S. Sanchez-Garcia1, C. Gamez2, E. Lopez2, M. D. Iban˜ez3, C. Escudero3, M. F. Madero1, M. T. Laso3, V. del Pozo2, J. Sastre1; 1Service of Allergy. Fundacion Jimenez Diaz, Madrid, Spain, 2Service of Immunology. Fundacion Jimenez Diaz, Madrid, Spain, 3Service of Pediatrics Allergy. Hospital Infantil Universitario del Nin˜o Jesus., Madrid, Spain. RATIONALE: Our study aimed to investigate clinical characteristics and allergens recognized by patients with suspected shrimp allergy. METHODS: We studied 35 patients with suspected allergic reactions to shrimp, mostly urticaria. In all patients double-blind placebo controlled oral challenge (DBPCOC) was performed. Prick-by-prick tests and serum specific IgE (CAP system) with mites, anisakis, mosquito, cockroach, shrimp, clam, snail, mussel, scallop, cockle, squid, octopus and cuttlefish were performed as well as IgE to rPen a1 (tropomyosin). All patient’s sera were tested individually by IgE immunodetection after SDS-PAGE with shrimp crude extract. Seven patients sensitized to mites and with good tolerance to shrimp were included as controls. RESULTS: 20 (57%) patients were considered allergic (14 1 DBPCOC and 6 anaphylaxis). Specific IgE was positive to all of extracts tested by CAP, except in 2 patients. 17 were sensitized to mites. All but 2 had specific IgE to tropomyosin, in 1 only detected by immunoblotting. In patients with negative DBPCOC, 5 had specific IgE to other seafood and 10 to mites. In the control group all CAP determinations were negative except in one patient who had specific IgE to shrimp and other patient a 37 kDa IgE-binding band. Immunoblots demonstrated several IgE bindingbands. The main bands were of 37 and 20 kDa in 12 allergic patients. These bands were also detected in 3 patients with negative DBPCOC. CONCLUSIONS: This study shows the need to perform food challenges for a correct diagnosis. Tropomyosin seems the major allergen in shrimp allergic patients in Spain, although, other allergens may be implicated.
75
Correlation Of Oral Allergy Syndrome Due To Plant-derived Foods With Pollens In Japan N. Maeda, N. Inomata, A. Morita, M. Kirino, Z. Ikezawa; Yokohama City University Hosipital, Yokohama, Japan. RATIONALE: The clinical features of patients with oral allergy syndrome (OAS) due to plant-derived foods have been rarely reported in Japan. We investigated whether pollen sensitizations would be correlated with prevalence of OAS. METHODS: We measured specific IgE antibodies (ImmunoCAP: CAP) against Japanese cedar, alder, orchard grass, ragweed, and mugwort in 622 outpatients (M: F 5 277:345, mean age, 37 years) with skin allergy over a two-year period.We statistically analyzed whether there was any correlation between prevalence of OAS and sensitization to the pollens. RESULTS: Prevalence of OAS is 2.3% in outpatients with skin allergy. Ratios of positive response to CAP against Japanese cedar, alder, orchard grass, ragweed, and mugwort were 69.8%, 24.1%, 29.1%, and 35.3%, respectively. Prevalence of OAS showed a significant positive correlation (p < 0.001) with sensitization to alder, but no correlation with sensitization to Japanese cedar, orchard grass, ragweed, and mugwort. The most frequent causative foods were found to be apple, peach, melon, and kiwi. Prevalence of OAS due to apple showed a significant positive correlation (p < 0.001) with sensitization to alder. Prevalence of OAS due to peach showed a significant positive correlation (p < 0.001 and p < 0.05) with sensitization to alder and orchard grass. Further, prevalence of OAS due to melon showed a significant positive correlation (p < 0.005, p < 0.05 and p < 0.05) with sensitization to alder, orchard grass, and ragweed. CONCLUSIONS: In this study, it was suggested that the sensitization to the pollens from species belonging to Betulaceae family would be most strongly involved in prevalence of OAS in Japan as same as in Northern and Center Europe.
SATURDAY
Abstracts S23
J ALLERGY CLIN IMMUNOL VOLUME 123, NUMBER 2