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Food Allergy in Pediatrics Liver Transplant Recipients
AB96 Abstracts
J ALLERGY CLIN IMMUNOL FEBRUARY 2013
SUNDAY
347
Food Allergy in Pediatrics Liver Transplant Recipients Ratchaneewan Sinitkul, PhD, Suporn Treepongkaruna, Sumate Teeraratkul, Wasu Kamchaisatian, MD, Wiparat Manuyakorn, MD, Soamarat Vilaiyuk, MD, Cherapat Sasisakulporn, BSc, Wanlapa Teawsomboonkit, RN, Suwat Benjaponpitak, MD; Ramathibodi Hospital, Bangkok, Thailand. RATIONALE: Prevalence of food allergy (FA) has been increasing in pediatrics liver transplants (LT) recipients. This study was aimed to identify relative risk factors and characterize the manifestations of food allergy in this special group. METHODS: Medical records of pediatrics LT recipients from Jan 2001-Mar 2012 were reviewed. Food allergy was diagnosed from history of symptom and improvement after avoidance. Evidence of sensitization was confirmed by serum specific IgE or skin prick test. RESULTS: Among 46 patients, 25 (54.35%) patients had FA. Median follow up time post-LT was 2.42 (0.42, 11.58) year. FA developed at a median time 2 years post-LT (95%CI 1.25 to 4.33). Manifestations of FA were gastrointestinal symptoms (52%), urticaria/angioedema (32%), eczema (28%), anaphylaxis (8%), anemia (8%), stridor (8%). Fourteen patients (56%) had multiple food allergies. Causative foods were milk (52%), seafood (40%), egg (28%), wheat (28%), soybean (28%) peanut (28%), coconut milk (16%), fish (8%) and monosodium glutamate (4%). Incidence of FAwas 33% at the first year post LT then decline to 17%, 10 % and 7% in the following year. Risk factors were aged less than 2 year at transplantation (Hazard ratio 2.62, 95%CI 1.04 to 6.59) and Epstein-Barr (EBV) viremia (Hazard ratio 2.39, 95%CI 1.02 to 5.63). However, neither donors nor recipients atopic status were significantly associated with the risk for developing food allergy. CONCLUSIONS: Food allergy after liver transplantation in pediatric patients is not uncommon. Age at transplantation less than 2 years and EBV viremia are risk factors for developing FA.
Relationship Between Socioeconomic and Sociodemographic Risk Factors and Atopic Dermatitis in Korean Adolescents Yeong-Ho Rha, MD, PhD1, Kyung Suk Lee, MD, PhD1, Sun-Hee Choi, MD, PhD2; 1Kyung Hee University Hospital, 2Gangdong Kyung Hee University Hospital. RATIONALE: There have been numerous studies in an attempt to prevent and treat atopic dermatitis (AD), and as a result, many medical, socioeconomic and sociodemographic risk factors have already been suggested. We conducted this study specifically focusing on the relationship between various socioeconomic and demographic variables, and AD in Korean adolescents. METHODS: In this study, 79,202 Korean adolescents aged 12 to 18 years who participated in the 2010 Korea Youth Risk Behavior Web-Based Survey(KYRBWS, 2010) were used as sample. Dependent variable was atopic dermatitis; independent variables were gender, parents’ education level, FAS, low subjective family economic status, and obesity. These were collected by the self-answering surveying method. Multivariate analysis was conducted in order to analyze the relationship between socioeconomic and sciodemographic risk factors and AD. RESULTS: The prevalence of AD based on 2010 KYRBWS in Korean adolescents was 23.1%. In univariate analysis, female, urban, high parental education level, family affluence scale was strongly correlated with AD. In multivariate analysis, female, urban, college or higher parental education level, obesity, high family affluence scale, low subjective family economic status were correlated with AD. CONCLUSIONS: This study proved that Korean adolescents’ AD was strongly correlated with socioeconomic and sociodemographic risk factors. Thus, it is utmost important to modulate the socioeconomic and sociodemographic risk factors to control AD systematically in adolescent in Korea.
348
350
Risk Factors of Extrinsic and Intrinsic Atopic Dermatitis in Korean Adolescents Kyung-Suk Lee, MD, PhD1, Sun-Hee Choi, MD, PhD2, Yeong-Ho Rha, MD, PhD1; 1Kyung Hee University Hospital, 2Gangdong Kyung Hee University Hospital. RATIONALE: Atopic dermatitis (AD) can be classified into Extrinsic (EAD) and intrinsic AD (IAD) based on presence of specific IgE(sIgE). Even though it is known that EAD shows severer clinical signs, no study with comparative analysis on EAD and IAD has been done in Korea. We analyzed EAD and IAD sample data to identify their risk factors among Korean adolescents. METHODS: Based upon the data from Korea National Health & Nutrition Examination Survey(KNHNES V-1, 2010) on 12-18 year old adolescents’ prevalence rate, the various variables presumably related to AD, including age, gender, income, habitat(rural/urban), obesity, smoking, drinking, vitamin D and total IgE (tIgE) concentration in blood, were used for statistical analysis. RESULTS: The group with positive slgE, especially male, showed significantly higher level in vitamin D and tlgE concentration in blood than negative slgE group in general survey population. Prevalence rate of EAD and IAD were 7.2% and 5.8% respectively. The tlgE concentration of EAD and IAD were respectively 356.5 mg/dL (quartile 194.5-708.0) and 109.6 mg/dL (quartile 53.2-243.3), showing a significant difference; however, there was no significant difference in other variables. The risk factors for EAD were the high tlgE concentration (OR, 8.4; 95% Cl, 4.0-17.7; p<0.000) and smoking (6.7;1.1-42.3; p<0.042), and the risk factors for IAD was obesity (4.4; 1.1-17.4; p<0.037). CONCLUSIONS: In comparison between EAD and IAD, tlgE and smoking were found to be the risk factors for EAD and obesity for intrinsic AD. Therefore, the prevention of adolescent AD requires moderation in smoking for EAD and in body-weight control for IAD.
349
Delayed Introduction of Food and Effect On Incidence of Food Allergy in a Population At High Risk for Atopy: The Canadian Asthma Primary Prevention Study (CAPPS) Tiffany Wong, MD1, Moira Chan-Yeung, MB2, Roxanne Rousseau, BSc2, Anne Dybuncio, BS2, Anita L. Kozyrskyj, PhD3, Clare Ramsey, MD, MSc, FRCPC4, Allan Becker, MD, FAAAAI5, Edmond S. Chan, MD, FAAAAI1; 1Department of Pediatrics, Faculty of Medicine, University of British Columbia, 2Department of Medicine, Faculty of Medicine, University of British Columbia, 3University of Manitoba, Edmonton, AB, Canada, 4Department of Medicine, Faculty of Medicine, University of Manitoba, 5University Of Manitoba, Winnipeg, MB, Canada. RATIONALE: Recommendations for timing of solid food introduction have changed over the last decade, with current guidelines suggesting no benefit to delay beyond 4 to 6 months of age. METHODS: 545 infants with an immediate family history of asthma and/ or allergy were randomized before birth into intervention (multifaceted modified diet, lifestyle and environment with encouragement of breastfeeding and delayed introduction of solids) or control groups. Participants were prospectively assessed by pediatric allergists at 1,2,7 and 15 years. Sensitization to foods (including cow milk, egg, soy, wheat and peanut) was assessed by prick testing. RESULTS: At 15 years of age, 325 children were assessed (149 control, 176 intervention). 1.7% (3/176) of the intervention group were sensitized to cow milk, 2.27% (4/176) to egg, 2.27% (4/176) to soy, 1.7% (3/176) to wheat, and 10.8% (19/176) to peanut. In comparison, 1.34% (2/149) of the control group were sensitized to cow’s milk (p50.578), 1.34% (2/149) to egg (p50.434), 1.34% (2/149) to soy (p50.434), 0.67% (1/149) to wheat (p50.376), and 10.74% (16/149) to peanut (P50.566). There was no difference in rate of sensitization to food for infants who were breastfed versus formula fed. CONCLUSIONS: Interventions did not increase or decrease food sensitization at 15 years of age or any of the other assessed ages. Other risk factors may play a greater role in determining food sensitization.
J ALLERGY CLIN IMMUNOL FEBRUARY 2013
SUNDAY
347
Food Allergy in Pediatrics Liver Transplant Recipients Ratchaneewan Sinitkul, PhD, Suporn Treepongkaruna, Sumate Teeraratkul, Wasu Kamchaisatian, MD, Wiparat Manuyakorn, MD, Soamarat Vilaiyuk, MD, Cherapat Sasisakulporn, BSc, Wanlapa Teawsomboonkit, RN, Suwat Benjaponpitak, MD; Ramathibodi Hospital, Bangkok, Thailand. RATIONALE: Prevalence of food allergy (FA) has been increasing in pediatrics liver transplants (LT) recipients. This study was aimed to identify relative risk factors and characterize the manifestations of food allergy in this special group. METHODS: Medical records of pediatrics LT recipients from Jan 2001-Mar 2012 were reviewed. Food allergy was diagnosed from history of symptom and improvement after avoidance. Evidence of sensitization was confirmed by serum specific IgE or skin prick test. RESULTS: Among 46 patients, 25 (54.35%) patients had FA. Median follow up time post-LT was 2.42 (0.42, 11.58) year. FA developed at a median time 2 years post-LT (95%CI 1.25 to 4.33). Manifestations of FA were gastrointestinal symptoms (52%), urticaria/angioedema (32%), eczema (28%), anaphylaxis (8%), anemia (8%), stridor (8%). Fourteen patients (56%) had multiple food allergies. Causative foods were milk (52%), seafood (40%), egg (28%), wheat (28%), soybean (28%) peanut (28%), coconut milk (16%), fish (8%) and monosodium glutamate (4%). Incidence of FAwas 33% at the first year post LT then decline to 17%, 10 % and 7% in the following year. Risk factors were aged less than 2 year at transplantation (Hazard ratio 2.62, 95%CI 1.04 to 6.59) and Epstein-Barr (EBV) viremia (Hazard ratio 2.39, 95%CI 1.02 to 5.63). However, neither donors nor recipients atopic status were significantly associated with the risk for developing food allergy. CONCLUSIONS: Food allergy after liver transplantation in pediatric patients is not uncommon. Age at transplantation less than 2 years and EBV viremia are risk factors for developing FA.
Relationship Between Socioeconomic and Sociodemographic Risk Factors and Atopic Dermatitis in Korean Adolescents Yeong-Ho Rha, MD, PhD1, Kyung Suk Lee, MD, PhD1, Sun-Hee Choi, MD, PhD2; 1Kyung Hee University Hospital, 2Gangdong Kyung Hee University Hospital. RATIONALE: There have been numerous studies in an attempt to prevent and treat atopic dermatitis (AD), and as a result, many medical, socioeconomic and sociodemographic risk factors have already been suggested. We conducted this study specifically focusing on the relationship between various socioeconomic and demographic variables, and AD in Korean adolescents. METHODS: In this study, 79,202 Korean adolescents aged 12 to 18 years who participated in the 2010 Korea Youth Risk Behavior Web-Based Survey(KYRBWS, 2010) were used as sample. Dependent variable was atopic dermatitis; independent variables were gender, parents’ education level, FAS, low subjective family economic status, and obesity. These were collected by the self-answering surveying method. Multivariate analysis was conducted in order to analyze the relationship between socioeconomic and sciodemographic risk factors and AD. RESULTS: The prevalence of AD based on 2010 KYRBWS in Korean adolescents was 23.1%. In univariate analysis, female, urban, high parental education level, family affluence scale was strongly correlated with AD. In multivariate analysis, female, urban, college or higher parental education level, obesity, high family affluence scale, low subjective family economic status were correlated with AD. CONCLUSIONS: This study proved that Korean adolescents’ AD was strongly correlated with socioeconomic and sociodemographic risk factors. Thus, it is utmost important to modulate the socioeconomic and sociodemographic risk factors to control AD systematically in adolescent in Korea.
348
350
Risk Factors of Extrinsic and Intrinsic Atopic Dermatitis in Korean Adolescents Kyung-Suk Lee, MD, PhD1, Sun-Hee Choi, MD, PhD2, Yeong-Ho Rha, MD, PhD1; 1Kyung Hee University Hospital, 2Gangdong Kyung Hee University Hospital. RATIONALE: Atopic dermatitis (AD) can be classified into Extrinsic (EAD) and intrinsic AD (IAD) based on presence of specific IgE(sIgE). Even though it is known that EAD shows severer clinical signs, no study with comparative analysis on EAD and IAD has been done in Korea. We analyzed EAD and IAD sample data to identify their risk factors among Korean adolescents. METHODS: Based upon the data from Korea National Health & Nutrition Examination Survey(KNHNES V-1, 2010) on 12-18 year old adolescents’ prevalence rate, the various variables presumably related to AD, including age, gender, income, habitat(rural/urban), obesity, smoking, drinking, vitamin D and total IgE (tIgE) concentration in blood, were used for statistical analysis. RESULTS: The group with positive slgE, especially male, showed significantly higher level in vitamin D and tlgE concentration in blood than negative slgE group in general survey population. Prevalence rate of EAD and IAD were 7.2% and 5.8% respectively. The tlgE concentration of EAD and IAD were respectively 356.5 mg/dL (quartile 194.5-708.0) and 109.6 mg/dL (quartile 53.2-243.3), showing a significant difference; however, there was no significant difference in other variables. The risk factors for EAD were the high tlgE concentration (OR, 8.4; 95% Cl, 4.0-17.7; p<0.000) and smoking (6.7;1.1-42.3; p<0.042), and the risk factors for IAD was obesity (4.4; 1.1-17.4; p<0.037). CONCLUSIONS: In comparison between EAD and IAD, tlgE and smoking were found to be the risk factors for EAD and obesity for intrinsic AD. Therefore, the prevention of adolescent AD requires moderation in smoking for EAD and in body-weight control for IAD.
349
Delayed Introduction of Food and Effect On Incidence of Food Allergy in a Population At High Risk for Atopy: The Canadian Asthma Primary Prevention Study (CAPPS) Tiffany Wong, MD1, Moira Chan-Yeung, MB2, Roxanne Rousseau, BSc2, Anne Dybuncio, BS2, Anita L. Kozyrskyj, PhD3, Clare Ramsey, MD, MSc, FRCPC4, Allan Becker, MD, FAAAAI5, Edmond S. Chan, MD, FAAAAI1; 1Department of Pediatrics, Faculty of Medicine, University of British Columbia, 2Department of Medicine, Faculty of Medicine, University of British Columbia, 3University of Manitoba, Edmonton, AB, Canada, 4Department of Medicine, Faculty of Medicine, University of Manitoba, 5University Of Manitoba, Winnipeg, MB, Canada. RATIONALE: Recommendations for timing of solid food introduction have changed over the last decade, with current guidelines suggesting no benefit to delay beyond 4 to 6 months of age. METHODS: 545 infants with an immediate family history of asthma and/ or allergy were randomized before birth into intervention (multifaceted modified diet, lifestyle and environment with encouragement of breastfeeding and delayed introduction of solids) or control groups. Participants were prospectively assessed by pediatric allergists at 1,2,7 and 15 years. Sensitization to foods (including cow milk, egg, soy, wheat and peanut) was assessed by prick testing. RESULTS: At 15 years of age, 325 children were assessed (149 control, 176 intervention). 1.7% (3/176) of the intervention group were sensitized to cow milk, 2.27% (4/176) to egg, 2.27% (4/176) to soy, 1.7% (3/176) to wheat, and 10.8% (19/176) to peanut. In comparison, 1.34% (2/149) of the control group were sensitized to cow’s milk (p50.578), 1.34% (2/149) to egg (p50.434), 1.34% (2/149) to soy (p50.434), 0.67% (1/149) to wheat (p50.376), and 10.74% (16/149) to peanut (P50.566). There was no difference in rate of sensitization to food for infants who were breastfed versus formula fed. CONCLUSIONS: Interventions did not increase or decrease food sensitization at 15 years of age or any of the other assessed ages. Other risk factors may play a greater role in determining food sensitization.