J Korean Med Assoc.  2017 Mar;60(3):242-248. 10.5124/jkma.2017.60.3.242.

Food allergy in children: focus on IgE-mediated food allergy

Affiliations
  • 1Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea. jsjs87@ajou.ac.kr
  • 2Suwon Center for Environmental Diseases and Atopy, Suwon, Korea.

Abstract

Food allergy (FA) has become more common in recent decades, and it is a serious health problem in children. FA is divided into immunoglobulin E (IgE)-mediated and non-IgE-mediated FA based on its mechanism. FA most often develops early in life, affecting up to 10% of children, and increasing concerns have been raised regarding severe FA including food-induced anaphylaxis, especially in young children. The 2 most common food allergens worldwide are milk and eggs, while the third most common allergen varies among countries. In addition to a detailed and convincing history of diverse symptoms (involving the skin, gastrointestinal, respiratory, cardiovascular, and neurologic systems) after exposure to culprit foods, the following tools can be useful in the diagnosis of FA: the skin prick test, measurement of serum food-specific IgE antibodies, and the elimination or provocation test with suspected foods. The current recommended management of FA relies on the strict avoidance of causative foods; the immediate treatment of allergic reactions, including epinephrine use for food-induced anaphylaxis; and education to prevent further reactions. Emerging approaches for tolerance induction to FA, such as food immunotherapy, have been investigated, but concrete evidence for clinical application is lacking. This review presents a detailed overview of the pathogenesis of FA, its prevalence, common culprit foods, and its diagnosis and management, and additionally shares recent data on common causative foods in Korean infants and children.

Keyword

Food hypersensitivity; Child; Etiology; Culprit food; Therapeutics

MeSH Terms

Allergens
Anaphylaxis
Antibodies
Child*
Diagnosis
Education
Eggs
Epinephrine
Food Hypersensitivity*
Humans
Hypersensitivity
Immunoglobulin E
Immunoglobulins
Immunotherapy
Infant
Milk
Ovum
Prevalence
Skin
Allergens
Antibodies
Epinephrine
Immunoglobulin E
Immunoglobulins

Reference

1. Nowak-Wegrzyn A, Sampson HA, Sicherer SH. Kliegman RM, Stanton BF, St Geme JW, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 20th ed. Philadelphia: Elsevier;2016. p. 1137–1143.
2. Sicherer SH, Sampson HA. Food allergy: Epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014; 133:291–307.
Article
3. Korean Academy of Pediatric Allergy and Respiratory Disease. Food allergy. Korean Academy of Pediatric Allergy and Respiratory Disease. Textbook of pediatric allergy and respiratory diseases. Seoul: Ryo Moon Gak;2013. p. 211–228.
4. Longo G, Berti I, Burks AW, Krauss B, Barbi E. IgE-mediated food allergy in children. Lancet. 2013; 382:1656–1664.
Article
5. Savage J, Sicherer S, Wood R. The natural history of food allergy. J Allergy Clin Immunol Pract. 2016; 4:196–203.
Article
6. Berin MC, Chehade M. Mucosal immunology: an overview. In : Leung DY, Szefler SJ, Bonilla FA, Akdis CA, Sampson HA, editors. Pediatric allergy: principles and practice. 3rd ed. Edinburgh: Elsevier;2016. p. 365–370.
7. Berin MC, Mayer L. Can we produce true tolerance in patients with food allergy? J Allergy Clin Immunol. 2013; 131:14–22.
Article
8. Hoffmann-Sommergruber K, Mills EN. Food allergen protein families and their structural characteristics and application in component-resolved diagnosis: new data from the EuroPrevall project. Anal Bioanal Chem. 2009; 395:25–35.
Article
9. Lee S. A study for prevention and control of food allergy. Cheongju: Ministry of Food and Drug Safety;2015.
10. Song TW, Kim KW, Kim WK, Kim JH, Kim HH, Park YM, Ahn K, Yang HJ, Yum HY, Lee SY, Jeon YH, Pyun BY. Guide-lines for the oral food challenges in children. Pediatr Allergy Respir Dis. 2012; 22:4–20.
Article
11. Sampson HA. Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J Allergy Clin Immunol. 2001; 107:891–896.
Article
12. Sohn MH, Lee SY, Kim KE. Prediction of buckwheat allergy using specific IgE concentrations in children. Allergy. 2003; 58:1308–1310.
Article
13. Park K, Jeong K, Lee S. Clinical and laboratory findings of child-hood buckwheat allergy in a single tertiary hospital. Korean J Pediatr. 2016; 59:402–407.
Article
14. Kim J, Kim HY, Park MR, Choi J, Shim JY, Kim MJ, Han Y, Ahn K. Diagnostic decision points of specific IgE concentrations in Korean children with egg and cow's milk allergies. Allergy Asthma Immunol Res. 2015; 7:332–338.
Article
15. Min TK, Jeon YH, Yang HJ, Pyun BY. The clinical usefulness of IgE antibodies against egg white and its components in Korean children. Allergy Asthma Immunol Res. 2013; 5:138–142.
Article
16. Oh JW, Pyun BY, Choung JT, Ahn KM, Kim CH, Song SW, Son JA, Lee SY, Lee SI. Epidemiological change of atopic dermatitis and food allergy in school-aged children in Korea between 1995 and 2000. J Korean Med Sci. 2004; 19:716–723.
Article
17. Park M, Kim D, Ahn K, Kim J, Han Y. Prevalence of immediate-type food allergy in early childhood in seoul. Allergy Asthma Immunol Res. 2014; 6:131–136.
Article
18. Lee SY, Ahn K, Kim J, Jang GC, Min TK, Yang HJ, Pyun BY, Kwon JW, Sohn MH, Kim KW, Kim KE, Yu J, Hong SJ, Kwon JH, Kim SW, Song TW, Kim WK, Kim HY, Jeon YH, Lee YJ, Lee HR, Kim HY, Ahn Y, Yum HY, Suh DI, Kim HH, Kim JT, Kim JH, Park YM, Lee S. Korean Academy of Pediatric Allergy and Respiratory Diseases Food Allergy and Atopic Dermatitis Study Group. A multicenter retrospective case study of anaphylaxis triggers by age in Korean children. Allergy Asthma Immunol Res. 2016; 8:535–540.
Article
19. Jeong K, Lee SY, Ahn K, Kim J, Lee HR, Suh DI, Pyun BY, Min TK, Kwon JW, Kim KE, Kim KW, Sohn MH, Kim YH, Song TW, Kwon JH, Jeon YH, Kim HY, Kim JH, Ahn YM, Lee S. A multicenter study on anaphylaxis caused by peanut, tree nuts, and seeds in children and adolescents. Allergy. 2017; 72:507–510.
Article
20. Ministry of Food and Drug Safety. Allergenic Food Labeling Act 2015. Cheongju: Ministry of Food and Drug Safety;2015.
21. Song TW. A practical view of immunotherapy for food allergy. Korean J Pediatr. 2016; 59:47–53.
Article
22. Leonard SA, Sampson HA, Sicherer SH, Noone S, Moshier EL, Godbold J, Nowak-Wegrzyn A. Dietary baked egg accelerates resolution of egg allergy in children. J Allergy Clin Immunol. 2012; 130:473–480.
Article
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr