Atopic dermatitis is common in children with food allergies but is rarely caused by food

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Although food allergy appeared to be common among children with atopic dermatitis, only 3% had food-induced atopic dermatitis, according to a study published in Journal of Allergy and Clinical Immunology: in practice.

Because of the risks of eliminating foods unnecessarily, including nutritional deficiencies and loss of tolerance, a detailed history of food allergy should be obtained from patients with atopic dermatitis, including testing and oral nutritional challenges if indicated , Jennifer Chen Lee, MD, A fellow in allergy/immunology in the Division of Rheumatology, Allergy, and Immunology at Massachusetts General Hospital, and colleagues wrote.

Data were derived from Li JC, et al. Allergy Clean Immunol practice. 2022; doi: 10.1016/j.jaip.2022.05.028.

To differentiate the prevalence of food-induced Alzheimer’s disease from IgE-mediated food allergy, researchers performed a retrospective chart review of 372 children with Alzheimer’s disease who were referred to allergy and/or dermatologists at a tertiary care referral center with one or more From followers – to visits.

Children (63% boys, 76% white, 92% non-Hispanic) had a median age at first specialist visit of 1.1 years (range, 0-16 years), with 29% diagnosed with moderate Alzheimer’s disease and 18% were diagnosed with the severe condition. ad.

Most patients with AD (55%) had IgE-mediated food sensitivity, including 60% of those with mild AD, 45% of those with moderate AD, and 57% of those with severe AD. About two-thirds (67%) of patients with food allergy were male, and a greater proportion of patients with food allergy unaffected by IgE were <1 year old at the first visit (48% vs. 26%; s <.001).

The most common allergens associated with an instant food allergy include peanuts (44%) and eggs (43%). Also, 65% of patients with IgE-mediated food allergy had a skin prick test or IgE levels with positive predictive values ​​greater than 95%.

Food-triggered Alzheimer’s disease (FTAD) — defined by a physician who observed sustained improvement in Alzheimer’s disease after food removal — appeared uncommon, occurring in only 3% of the total group and 2% of patients with mild Alzheimer’s disease, and 6% of those with Alzheimer’s disease The light. Mild AD and 4% with severe AD.

Additionally, 4% of patients with an allergy to at least one food have FTAD for another food.

The most common allergens for FTAD are eggs (62%) and peanuts (31%). The OFC was used to confirm the diagnosis of approximately 30% of patients with FTAD.

Of the 97 patients referred only for Alzheimer’s disease and not food allergy, 29% had IgE-mediated food allergy, 13% had moderate Alzheimer’s disease, 28% had moderate Alzheimer’s disease, 41% had severe Alzheimer’s disease, and 5 % mild food allergy.

Very few patients may experience better outcomes for Alzheimer’s disease with an elimination diet, but risks include nutritional deficiencies and loss of stamina, the researchers added.

Providers should then carefully consider prescribing a food elimination diet for AD when there are no immediate food allergy symptoms, with clinical decision making focused on IgE-mediated food allergy symptoms in most cases.

The researchers concluded that even among patients referred only for Alzheimer’s disease, food allergy was common, although Alzheimer’s disease was rare. Noting that their study was retrospective, the researchers also said that future studies are necessary to characterize the relationship between food allergy and Alzheimer’s disease.

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