Age features of the IgE-dependent food hypersensitivity in children of different ages diagnosed with prick- and patch-tests
Background. Food hypersensitivity (FH) is commonly diagnosed in children. Positive skin tests and elevated serum IgE levels indicate anaphylactic mechanisms of allergy symptoms, although in some cases they do not correlate with clinical manifestation. Thus, the search for the effective approaches to the correct adjusted use of these methods in concordance with symptoms remains important. The purpose of our study was to evaluate age features of the IgE-dependent FH in children, which was proven with skin prick- and patch-tests, specific IgE (sIgE) levels. Materials and methods. The study included 148 patients aged 1 month to 18 years with skin symptoms of FH. The next methods were used: questioning, skin prick- and patch-tests, serum sIgE immunoassay detection. Results. 69.5 % of patients were children of early age — up to 3 years. Sensitization to the cow milk prevailed — 43 % (n = 10). 10 % of children had positive patch-tests with food allergens. Most part of children with non-IgE-dependent FH was 4–6 years old. Elevated total IgE levels were detected in 49 % of children. SIgE was increased in 42 % (n = 25) of children with normal total IgE, sIgE to cow milk and egg prevailed. Only in 63 % of children, high sIgE levels were clinically relevant and were proved with skin tests. The higher was children’s age the less was sIgE clinical relevance. Conclusions. Diagnostic algorithm of FH in children under and over 3 years should be different and take into account possible formation of the natural oral tolerance and decreased prevalence of the IgE-dependent reactions.
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