Proven Food-Induced Acute Urticaria and Predictive Factors for

Abstract

Background: Urticaria can be the only sign of a food allergy or can be seen together with other signs and symptoms of a food allergy. Objective: To determine the demographic, etiologic, and clinical features of food-induced acute urticaria in childhood. Methods: Patients suspected of food-induced acute urticaria were included in this prospective cross-sectional multicenter study. Results: Two hundred twenty-nine urticaria cases were included in this study. Seventeen patients who did not meet the inclusion criteria of the study were excluded. Of the 212 included cases, 179 (84.4%) were diagnosed with definitive food-induced acute urticaria. The most common foods causing acute urticaria were cow's milk, hen's eggs, and nuts in 56.4, 35.2, and 19% of cases, respectively. The positive predictive value of a history of milk-induced acute urticaria together with a milk-specific IgE >5 kU/L for cow's milk-induced acute urticaria was 92% (95% CI: 81-96%). A history of cow's milk-induced and/or hen's egg-induced acute urticaria was consistent with a definitive diagnosis of food-induced urticaria (Chen's kappa: 0.664 and 0.627 for milk and eggs, respectively). Urticaria activity scores were higher in patients with food-induced acute urticaria (p = 0.002). Conclusion: Cow's milk, hen's eggs, and nuts were the most common allergens in the etiology of childhood food-induced acute urticaria. Although the urticaria activity score provides guidance for diagnosis, an oral food challenge is often essential for the definitive diagnosis of a patient with a history of food-induced acute urticaria.

C1 [Aydogan, Metin; Simsek, Isil Eser; Cogurlu, Mujde Tugba] Kocaeli Univ, Fac Med, Pediat Allergy & Immunol Dept, Kocaeli, Turkey.

[Topal, Erdem; Kaplan, Fatih] Inonu Univ, Fac Med, Pediat Allergy & Immunol Dept, Malatya, Turkey.

[Uysal, Pinar] Adnan Menderes Univ, Fac Med, Pediat Allergy & Immunol Dept, Aydin, Turkey.

[Acar, Hazal Cansu] Istanbul Univ Cerrahpasa, Cerrahpasa Fac Med, Dept Publ Hlth, Istanbul, Turkey.

[Cavkaytar, Ozlem; Arga, Mustafa] Medeniyet Univ, Fac Med, Pediat Allergy & Immunol Dept, Istanbul, Turkey.

[Demirkale, Zeynep Hizli; Yucel, Esra; Tamay, Zeynep; Guler, Nermin; Ozdemir, Cevdet] Istanbul Univ, Fac Med, Pediat Allergy & Immunol Dept, Istanbul, Turkey.

[Aydogmus, Cigdem; Erdogan, Mehmet Sarper; Yesil, Yakup] Kanuni Sultan Suleyman Training & Res Hosp, Pediat Allergy & Immunol Dept, Istanbul, Turkey.

[Yakici, Nalan; Orhan, Fazil] Karadeniz Tech Univ, Fac Med, Pediat Allergy & Immunol Dept, Trabzon, Turkey.

[Aydemir, Sezin; Cokugras, Haluk; Kiykim, Ayca] Istanbul Univ Cerrahpasa, Cerrahpasa Fac Med, Pediat Allergy & Immunol Dept, Istanbul, Turkey.

[Akkelle, Emre] Sancaktepe Training & Res Hosp, Pediat Allergy & Immunol Dept, Istanbul, Turkey.

[Cekic, Sukru; Sapan, Nihat] Uludag Univ, Fac Med, Pediat Allergy & Immunol Dept, Bursa, Turkey.

[Gunaydin, Nursen Cigerci] Namik Kemal Univ, Fac Med, Pediat Allergy & Immunol Dept, Tekirdag, Turkey.

[Tuncel, Tuba] Katip Celebi Univ, Fac Med, Pediat Allergy & Immunol Dept, Izmir, Turkey.

[Ozdemir, Oner] Sakarya Univ, Fac Med, Pediat Allergy & Immunol Dept, Sakarya, Turkey.