J Korean Med Sci.  2019 Jan;34(2):e11. 10.3346/jkms.2019.34.e11.

Clinical Characteristics of Oral Allergy Syndrome in Children with Atopic Dermatitis and Birch Sensitization: a Single Center Study

• Kim KI
• Lee B
• Min TK
• Lee J
• Pyun BY
• Jeon YH

• KMID: 2440160
• DOI: http://doi.org/10.3346/jkms.2019.34.e11

Abstract

BACKGROUND
Oral allergy syndrome (OAS) is an immunoglobulin E (IgE)-mediated hypersensitivity that occurs frequently in older children with pollen sensitization. This study focused on the clinical characteristics of OAS in children with atopic dermatitis (AD) and birch sensitization. METHOD: s: A total of 186 patients aged 2-18 years with AD and birch sensitization were enrolled in this study between January 2016 and March 2017. Their levels of serum total IgE and birch- and ragweed-specific IgE (sIgE) were measured using ImmunoCAP (Thermo Fisher Scientific, Uppsala, Sweden). Information regarding causative foods and symptoms were obtained via interviews. The patients were divided into 3 groups according to their ages (group 1, 2-6 years; group 2, 7-12 years; and group 3, 13-18 years).
RESULTS
Eighty-one of the 186 (43.5%) children with AD who were sensitized to birch pollen were diagnosed as having OAS. The prevalence of OAS in group 1 (the children who had AD and birch sensitization aged 2-6 years) was 36.6%. A greater predominance of men was noted in the non-OAS group (77.1%) compared to the OAS group (60.5%). Apples were the most common causative food in group 2 and 3 while kiwis were the most common cause of OAS in group 1. There was a statistically significant correlation between birch-sIgE levels and the prevalence of OAS (P = 0.000). The cut-off value was 6.77 kUA/L with 55.6% sensitivity and 79.0% specificity (area under the curve 0.653).
CONCLUSION
In our study, the prevalence of OAS in children with AD and birch sensitization was 43.5%. Even in the preschool age group, the prevalence of OAS was considerable. Patients with high levels of birch-sIgE were more likely to have OAS. Clinicians should therefore be vigilant about OAS in patients with a high degree of sensitization to birch pollen and even young children if they have birch sensitization.

Keyword

Oral Allergy Syndrome; Children; Atopic Dermatitis; Birch

MeSH Terms

Betula*
Child*
Dermatitis, Atopic*
Humans
Hypersensitivity*
Immunoglobulin E
Immunoglobulins
Male
Malus
Methods
Pollen
Prevalence
Sensitivity and Specificity
Immunoglobulin E
Immunoglobulins