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Mothers of Food Allergic Children Over-Report Food Allergy in Themselves
AB172 Abstracts
650
Mothers of Food Allergic Children Over-Report Food Allergy in Themselves M. Makhija1, L. Arguelles2, C. Szychlinski1, R. G. Robison1, D. Caruso1,3, R. Kumar1, X. Wang4, J. Pongracic1; 1Children’s Memorial Hospital, Chicago, IL, 2Northwestern University Feinberg School of Medicine, Chicago, IL, 3Mary Ann and J. Milburn Smith Child Health Research Program, Children’s Memorial Hospital and Children’s Memorial Research Center, Chicago, IL, 4Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. RATIONALE: Mothers of food allergic children are more likely to be aware of symptoms of food allergy. We assessed the association of maternal self-report of food allergy(FA) with likely FA, defined by physician diagnosis and specific IgE (sIgE)>0.35kU/L, as well as with sIgE above the accepted 95% PPV cutoffs for clinical reactivity. METHODS: 1096 mothers, with at least 1 child with FA, were administered standardized interview questionnaires. They were asked to report symptoms of FA and physician diagnosis of FA. Specific IgE testing was performed using Phadia Immunocap assay(Uppsala, Sweden). 9 foods (peanut, milk, egg, walnut, soy, wheat, shrimp, codfish, and sesame) were assessed. X2 tests compared associations of maternal self-report of allergy with likely food allergy (physician diagnosis and sIgE>0.35kU/L), as well as with sIgE above accepted 95% PPV cutoffs for clinical reactivity to milk, egg and peanut. RESULTS: Of 1096 mothers, 20.2% reported FA. Of the mothers reporting FA, 35.5% had detectable sIgE to one of the 9 foods tested and 19.8% had likely allergy. Likely allergy ranged from 3.6% for milk to 44.4% for peanut. For all foods, the association between maternal selfreported allergy and likely allergy was significant(p<0.0001). 18.5% of mothers reporting peanut allergy, 3.6% reporting milk allergy and none reporting egg allergy had IgE levels above established cutoffs for 95% PPV for clinical reactivity. CONCLUSION: Most mothers of food allergic children who self-report FA do not have detectable sIgE to suspected foods or likely FA and only a small percentage have sIgE meeting the accepted cutoffs for clinical reactivity.
MONDAY
651
Identification of Peanuts and Tree nuts by Guardians of NutAllergic Children L. Kao1, P. S. Bhangoo2, J. A. Bird1; 1UT Southwestern, Dallas, TX, 2 Children’s Medical Center, Dallas, TX. RATIONALE: Accurate identification and avoidance of peanuts and tree nuts are imperative to keep nut-allergic children safe. We hypothesized that primary guardians of nut-allergic children can accurately identify nuts better than guardians of children without a peanut or nut allergy. METHODS: A nut box was constructed containing samples of 14 common nuts with and without shells. Guardians of children attending the Food Allergy Clinic at the Children’s Medical Center were asked to identify each nut. The total score was calculated by total number of nuts correctly identified (maximum score of 14). Data were analyzed using the Mann-Whitney test. RESULTS: Sixty-six guardians of nut-allergic children and 50 guardians of children without a nut allergy (controls) were enrolled. The mean total score among all subjects was 8.8 out of 14 (63%). Guardians of nut-allergic children did not identify nuts better than controls (mean total score of 9.13 and 8.36 respectively, p50.09). Among all subjects, peanuts in the shell were correctly identified most often (95%), and Brazil nuts (24%) and hazelnuts (25%) were correctly identified least often. CONCLUSIONS: Overall, both groups performed poorly in identifying several nuts especially Brazil nuts and hazelnuts, and guardians of nut allergic children did not identify nuts better than control subjects. Therefore, guardians of children allergic to one or more tree nuts should be instructed to avoid feeding their children all tree nuts.
J ALLERGY CLIN IMMUNOL FEBRUARY 2012
652
The High Rate Of Cow'S Milk Sensitization In Asian Children Is Associated With The Amount Of Cow'S Milk Ingestion P. Vatanasurkitt, N. Saengsawang, N. Suratannon, N. Voraphani, P. Chatchatee, Ngamphaiboon J.; Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, THAILAND. RATIONAL: Specific IgE antibody to cow’s milk reflects sensitization. Information about pattern of cow’s milk sensitization and associated factors is limited in Asian countries. We investigated the prevalence rates of sensitization to cow’s milk in children from birth until 7 years old. METHODS: Sera from 284 healthy children were measured for cow’s milk specific IgE (CM s-IgE) by FEIA method, ImmunoCAP system. The _ 0.35 kUA/L. The questionnaires about associated factors cutoff level is > were answered by the parents. RESULTS: The overall prevalence of positive cow’s milk specific IgE among patients from all ages was 25% with the average level of 0.34 (+ 0.87), range 0 - 6.96 kUA/L. The highest prevalence rate was in the age of 2-4 year olds (31.8%). The sensitization rates and average levels according to ages were as follows; from birth to 6 months (12.7%, 0.09 kUA/L), 6 months-1 year old (31.7%, 0.47 kUA/L), 1-2 year olds (26.7%, 0.46 kUA/ L), 2-4 year olds (31.8%, 0.43 kUA/L) and 4-7 year olds (24.1%, 0.28 kUA/ L), respectively. The level of CM s-IgE was correlated with the amount of cow’s milk intake of the subjects (R50.16, P< 0.01). Additionally, the percentages of sensitization in the exclusive compared with non-exclusive breast-fed were significantly different (10% vs 26.77%, p< 0.05). CONCLUSIONS: Sensitization to cow’s milk protein is not uncommon in children under 4 years. The amount of cow’ milk ingestion is associated with the increasing rates of sensitization. Exclusive breast-feeding may decrease the rate of sensitization.
650
Mothers of Food Allergic Children Over-Report Food Allergy in Themselves M. Makhija1, L. Arguelles2, C. Szychlinski1, R. G. Robison1, D. Caruso1,3, R. Kumar1, X. Wang4, J. Pongracic1; 1Children’s Memorial Hospital, Chicago, IL, 2Northwestern University Feinberg School of Medicine, Chicago, IL, 3Mary Ann and J. Milburn Smith Child Health Research Program, Children’s Memorial Hospital and Children’s Memorial Research Center, Chicago, IL, 4Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. RATIONALE: Mothers of food allergic children are more likely to be aware of symptoms of food allergy. We assessed the association of maternal self-report of food allergy(FA) with likely FA, defined by physician diagnosis and specific IgE (sIgE)>0.35kU/L, as well as with sIgE above the accepted 95% PPV cutoffs for clinical reactivity. METHODS: 1096 mothers, with at least 1 child with FA, were administered standardized interview questionnaires. They were asked to report symptoms of FA and physician diagnosis of FA. Specific IgE testing was performed using Phadia Immunocap assay(Uppsala, Sweden). 9 foods (peanut, milk, egg, walnut, soy, wheat, shrimp, codfish, and sesame) were assessed. X2 tests compared associations of maternal self-report of allergy with likely food allergy (physician diagnosis and sIgE>0.35kU/L), as well as with sIgE above accepted 95% PPV cutoffs for clinical reactivity to milk, egg and peanut. RESULTS: Of 1096 mothers, 20.2% reported FA. Of the mothers reporting FA, 35.5% had detectable sIgE to one of the 9 foods tested and 19.8% had likely allergy. Likely allergy ranged from 3.6% for milk to 44.4% for peanut. For all foods, the association between maternal selfreported allergy and likely allergy was significant(p<0.0001). 18.5% of mothers reporting peanut allergy, 3.6% reporting milk allergy and none reporting egg allergy had IgE levels above established cutoffs for 95% PPV for clinical reactivity. CONCLUSION: Most mothers of food allergic children who self-report FA do not have detectable sIgE to suspected foods or likely FA and only a small percentage have sIgE meeting the accepted cutoffs for clinical reactivity.
MONDAY
651
Identification of Peanuts and Tree nuts by Guardians of NutAllergic Children L. Kao1, P. S. Bhangoo2, J. A. Bird1; 1UT Southwestern, Dallas, TX, 2 Children’s Medical Center, Dallas, TX. RATIONALE: Accurate identification and avoidance of peanuts and tree nuts are imperative to keep nut-allergic children safe. We hypothesized that primary guardians of nut-allergic children can accurately identify nuts better than guardians of children without a peanut or nut allergy. METHODS: A nut box was constructed containing samples of 14 common nuts with and without shells. Guardians of children attending the Food Allergy Clinic at the Children’s Medical Center were asked to identify each nut. The total score was calculated by total number of nuts correctly identified (maximum score of 14). Data were analyzed using the Mann-Whitney test. RESULTS: Sixty-six guardians of nut-allergic children and 50 guardians of children without a nut allergy (controls) were enrolled. The mean total score among all subjects was 8.8 out of 14 (63%). Guardians of nut-allergic children did not identify nuts better than controls (mean total score of 9.13 and 8.36 respectively, p50.09). Among all subjects, peanuts in the shell were correctly identified most often (95%), and Brazil nuts (24%) and hazelnuts (25%) were correctly identified least often. CONCLUSIONS: Overall, both groups performed poorly in identifying several nuts especially Brazil nuts and hazelnuts, and guardians of nut allergic children did not identify nuts better than control subjects. Therefore, guardians of children allergic to one or more tree nuts should be instructed to avoid feeding their children all tree nuts.
J ALLERGY CLIN IMMUNOL FEBRUARY 2012
652
The High Rate Of Cow'S Milk Sensitization In Asian Children Is Associated With The Amount Of Cow'S Milk Ingestion P. Vatanasurkitt, N. Saengsawang, N. Suratannon, N. Voraphani, P. Chatchatee, Ngamphaiboon J.; Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, THAILAND. RATIONAL: Specific IgE antibody to cow’s milk reflects sensitization. Information about pattern of cow’s milk sensitization and associated factors is limited in Asian countries. We investigated the prevalence rates of sensitization to cow’s milk in children from birth until 7 years old. METHODS: Sera from 284 healthy children were measured for cow’s milk specific IgE (CM s-IgE) by FEIA method, ImmunoCAP system. The _ 0.35 kUA/L. The questionnaires about associated factors cutoff level is > were answered by the parents. RESULTS: The overall prevalence of positive cow’s milk specific IgE among patients from all ages was 25% with the average level of 0.34 (+ 0.87), range 0 - 6.96 kUA/L. The highest prevalence rate was in the age of 2-4 year olds (31.8%). The sensitization rates and average levels according to ages were as follows; from birth to 6 months (12.7%, 0.09 kUA/L), 6 months-1 year old (31.7%, 0.47 kUA/L), 1-2 year olds (26.7%, 0.46 kUA/ L), 2-4 year olds (31.8%, 0.43 kUA/L) and 4-7 year olds (24.1%, 0.28 kUA/ L), respectively. The level of CM s-IgE was correlated with the amount of cow’s milk intake of the subjects (R50.16, P< 0.01). Additionally, the percentages of sensitization in the exclusive compared with non-exclusive breast-fed were significantly different (10% vs 26.77%, p< 0.05). CONCLUSIONS: Sensitization to cow’s milk protein is not uncommon in children under 4 years. The amount of cow’ milk ingestion is associated with the increasing rates of sensitization. Exclusive breast-feeding may decrease the rate of sensitization.