Allergy Asthma Immunol Res.  2017 Sep;9(5):423-430. 10.4168/aair.2017.9.5.423.

Age-Based Causes and Clinical Characteristics of Immediate-Type Food Allergy in Korean Children

• Jeong K
• Kim J
• Ahn K
• Lee SY
• Min TK
• Pyun BY
• Kim YH
• Kim KW
• Sohn MH
• Kim KE
• Jang GC
• Song TW
• Kim JH
• Jeon YH
• Lee YJ
• Park YM
• Yum HY
• Kim HH
• Kim WK
• Lee S

• KMID: 2383990
• DOI: http://doi.org/10.4168/aair.2017.9.5.423

Abstract

PURPOSE
Age-based causes and clinical characteristics of immediate-type food allergy (FA) have not been sufficiently studied. Therefore, we investigated age-dependent clinical profiles of FA in Korean children through an extensive multicenter investigation.
METHODS
Using a case report form developed by the authors, a retrospective medical record review was performed of patients (0-18 years old) diagnosed with immediate-type FA between September 2014 and August 2015 in 14 tertiary hospitals in Korea.
RESULTS
A total of 1,353 children and adolescents, 93% younger than 7 years, were enrolled in the present study, and 1,661 cases of immediate-type FA were recorded in these patients. The 7 major causative foods were cow's milk (28.1%), hen's eggs (27.6%), wheat (7.9%), walnuts (7.3%), peanuts (5.3%), buckwheat (1.9%), and shrimps (1.9%). Categorizing the patients into 4 age groups revealed that the most common causative food was different for each age group: cow's milk (<2 years), walnuts (2-6 years), walnuts (7-12 years), and buckwheat (13-18 years). The onset time of symptoms was less than 10 minutes in 49%, between 10 and 30 minutes in 17%, and between 30 minutes and 2 hours in 34% of cases. Food-induced anaphylaxis was reported in 506 (30.5%) out of 1,661 cases, and the 7 major causes of food-induced anaphylaxis was cow's milk (27.5%), hen's eggs (21.9%), wheat (11.3%), walnuts (10.5%), peanuts (5.9%), buckwheat (4.2%), and pine nuts (3.0%). The proportion of anaphylaxis was highest in the patients allergic to buckwheat (67.7%), followed by those allergic to pine nuts (57.7%), walnuts (43.8%), wheat (43.5%), and peanuts (34.1%).
CONCLUSIONS
The 5 major causative foods of immediate-type FA in Korean children were cow's milk, hen's eggs, wheat, walnuts, and peanuts. The distribution of causative foods was considerably distinctive according to different age groups. Anaphylaxis was reported in 30.5% of immediate-type FA cases.

Keyword

Food hypersensitivity; anaphylaxis; IgE-mediated; children; adolescents

MeSH Terms

Adolescent
Anaphylaxis
Arachis
Child*
Eggs
Fagopyrum
Food Hypersensitivity*
Humans
Juglans
Korea
Medical Records
Milk
Nuts
Ovum
Retrospective Studies
Tertiary Care Centers
Triticum

Figure

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  Fig. 1 (A) Causes of immediate-type food allergy in Korean children (individual food items, 0–18 years). (B) Causes of immediate-type food allergy in Korean children (food groups, 0–18 years). *Others: rice, tomato, shellfish, cuttlefish, melon, duck, pistachio, lobster, tuna, salmon, codfish, and processed foods.

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  Fig. 2 Onset time of immediate-type food allergy in Korean children.

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  Fig. 3 (A) Symptoms of immediate-type food allergy in Korean children (0–18 years). (B) Symptoms of immediate-type FA in Korean children by age groups. *Individual symptoms of anaphylaxis were not separately counted as cutaneous, respiratory, cardiovascular, gastrointestinal, nor neurologic & general.

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  Fig. 4 Place of occurrence of immediate-type food allergy in Korean children.

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  Fig. 5 Major causes of food-induced anaphylaxis in Korean children (0–18 years).

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  Fig. 6 Proportion of anaphylaxis according to different causative foods (0–18 years). *Proportion of anaphylaxis higher than 40%.

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