Allergy Asthma Immunol Res.  2019 Sep;11(5):723-735. 10.4168/aair.2019.11.5.723.

Clinical Features and Culprit Food Allergens of Korean Adult Food Allergy Patients: A Cross-Sectional Single-Institute Study

• Lee SC
• Kim SR
• Park KH
• Lee JH
• Park JW

• KMID: 2452761
• DOI: http://doi.org/10.4168/aair.2019.11.5.723

Abstract

PURPOSE
To investigate the causative allergens and clinical characteristics of Korean adult patients with food allergy (FA).
METHODS
This retrospective, cross-sectional single-institutional study enrolled Korean adult patients (n = 812) suspected of having FA. For diagnosis, causality assessment history taking, ImmunoCAP specific immunoglobulin E measurement and/or skin prick test were performed.
RESULTS
Among 812 patients, 415 were diagnosed as having FA. The most common causative allergen was fruit, with a diagnosis of pollen food allergy syndrome (PFAS: 155, 37.3%), followed by crustaceans (111, 26.7%), wheat (63, 15.1%), fruits in patients without PFAS(43, 10.3%), buckwheat (31, 7.4%), peanut (31, 7.4%), walnut (25, 6.0%), red meat due to reaction to galactose-α-1,3-galactose (α-Gal) (8, 1.9%), and silkworm pupa (13, 3.1%). Allergy to egg, milk, fish, or shellfish was rare in Korean adults. One-third of patients with FA exhibited multiple FAs (238/415, 57.3%); the average number of causative allergens was 2.39. About 129 patients (31.0%) were diagnosed as having anaphylaxis; in these patients, wheat was the most frequent causative food. Twenty patients were further diagnosed with food-dependent exercise-induced anaphylaxis (FDEIA); all were due to wheat. In particular, crustaceans, wheat, PFAS, buckwheat, and red meat (α-Gal) were also frequent causes of anaphylaxis.
CONCLUSIONS
Wheat, fruits with or without PFAS, and crustaceans are important and frequent causative allergens in Korean adult FA; these allergens differ from those found in childhood FA. It is notable that non-classic allergies, such as PFAS, FDEIA, and α-Gal allergy, are the important causes of anaphylaxis in Korean adult FA.

Keyword

Adults; food allergy; food allergen; anaphylaxis; Korea

MeSH Terms

Adult*
Allergens*
Anaphylaxis
Arachis
Bombyx
Diagnosis
Fagopyrum
Food Hypersensitivity*
Fruit
Humans
Hypersensitivity
Immunoglobulin E
Immunoglobulins
Juglans
Korea
Milk
Ovum
Pollen
Pupa
Red Meat
Retrospective Studies
Shellfish
Skin
Triticum
Allergens
Immunoglobulin E
Immunoglobulins

Figure

• 

  Fig. 1 Proportion of food allergy subtypes and symptom manifestations: (A) food allergy subtypes, (B) symptom manifestations, and (C) symptom onset. α-Gal, galactose-α-1,3-galactose; FDEIA, food dependent exercise induced anaphylaxis; PFAS, pollen food allergy syndrome.

• 

  Fig. 2 Frequency of food allergens categorized by derivation: (A) grains and legumes, (B) nuts and seeds, (C) other vegetables, (D) fruits, (E) seafood, (F) meat, and (G) other.

• 

  Fig. 3 Proportion of anaphylaxis among food allergy patients. α-Gal, galactose-α-1,3-galactose. *P value <0.05.

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