Food sensitization rate and immediate-type food allergy incidence among infantile atopic dermatitis
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Yuki Ejiri, MD, Tetsuharu Manabe, MD, Noriyuki Yanagida, MD, Sakura Sato, MD, Motohiro Ebisawa, MD PhD FAAAAI
RATIONALE: Food allergies (FA) are internationally reported in 33–63% of atopic dermatitis (AD) cases, confirmed with double-blind placebo-controlled food challenge (DBPCFC). The purpose of this study is to investigate the incidence rate of immediate-type FA from AD infants.

METHODS: We conducted a retrospective chart review of 228 patients who visited our outpatient clinic from September 2012 to August 2014, diagnosed with AD, aged <12-months-old during their first visit, and did not exhibit immediate reactions to any foods. Follow up was continued up to 4-years of age to determine if FA developed.

RESULTS: Totally 183 of 228 (80%) AD infants exhibited sensitization to either hen’s egg, cow’s milk, wheat, or soybean; elevated antigen-specific IgE values ≥0.34 kU/L were detected between age of 4–11-months. Eighty-two infants developed FAs (36% of the total, 45% of the sensitized). The following incidences of FAs were noted among sensitized patients: hen’s egg, 56/169 (33%); cow’s milk, 37/93 (40%); wheat, 13/77 (17%); and soybean, 1/43 (2%). Patients without hen’s egg, wheat, or soybean sensitization in their infancy did not develop FAs. Three out of 120 patients without cow's milk sensitization during infancy subsequently developed cow’s milk FA, although all showed increased milk-specific IgE after age of 1 year.

CONCLUSIONS: The incidence rate of FA in AD infants in recent years was approximately 40%. It was possible to initiate ingestion from an early age by performing an oral food challenge, even in infants with AD and food sensitization. Therefore, it is important not to completely eliminate sensitized food.