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

Affiliations
  • 1Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. parkjw@yuhs.ac
  • 2Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
  • 3Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

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
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