J Korean Med Sci.  2020 Jan;35(3):e23. 10.3346/jkms.2020.35.e23.

Clinical and Laboratory Findings of Barley Allergy in Korean Children: a Single Hospital Based Retrospective Study

• Lee E
• Jeong K
• Lee J
• Jeon SA
• Park B
• Lee H
• Lee S

• KMID: 2468019
• DOI: http://doi.org/10.3346/jkms.2020.35.e23

Abstract

BACKGROUND
Barley is a grain that is consumed in various forms in Asia. Studies on barley allergy are limited to a few case reports about hypersensitivity reactions to beer, but there is no barley allergy study in children. This study aimed to identify the phenotype and immunologic findings in Korean children with barley allergy.
METHODS
Forty-two participants with a history of ingesting barley who underwent serum specific immunoglobulin E to barley (barley-sIgE) assay at the Department of Pediatrics in Ajou Medical Center were enrolled through a retrospective analysis of medical records from March 2008 to February 2018. The demographic characteristics, symptoms, and immunologic parameters of the patients were assessed.
RESULTS
Twenty subjects presented with clinical barley allergy (B-allergic group), and 22 were atopic controls without allergic reactions after the ingestion of barley (B-tolerant group). The median ages of the B-allergic and B-tolerant groups were 1 and 3 years, respectively. In the B-allergic group, the cutaneous system (90.0%) was most frequently affected, followed by the respiratory system (40.0%). Anaphylaxis was observed in 35.0% of the B-allergic group. The median level of barley-sIgE was 13.90 kU(A)/L (range, 0.14-101.00 kU(A)/L) in the B-allergic group, and this value was significantly higher (P < 0.001) than that of the B-tolerant group (0.30 kU(A)/L; range, 0.01-24.40 kU(A)/L), with an optimal cutoff level of 1.24 kU(A)/L (sensitivity, 85.0%; specificity, 86.4%). A positive correlation was found between the serum levels of barley-sIgE and wheat-sIgE in the B-allergic group with clinical wheat allergy.
CONCLUSION
Barley is an important allergen for children in Korea. This study showed the clinical characteristics of barley allergy and suggested optimal cut-off levels of barley-sIgE for clinical barley allergy. Clinically, cross-reactivity or co-sensitization is often observed between barley and wheat.

Keyword

Barley Allergy; Food Allergy; Specific IgE; Anaphylaxis

MeSH Terms

Anaphylaxis
Asia
Beer
Child*
Eating
Food Hypersensitivity
Hordeum*
Humans
Hypersensitivity*
Immunoglobulin E
Immunoglobulins
Korea
Medical Records
Pediatrics
Phenotype
Respiratory System
Retrospective Studies*
Sensitivity and Specificity
Triticum
Wheat Hypersensitivity
Immunoglobulin E
Immunoglobulins