PMID- 29684569
OWN - NLM
STAT- MEDLINE
DCOM- 20190305
LR  - 20190305
IS  - 1534-4436 (Electronic)
IS  - 1081-1206 (Linking)
VI  - 121
IP  - 1
DP  - 2018 Jul
TI  - Food allergy to previously tolerated foods: Course and patient characteristics.
PG  - 77-81.e1
LID - S1081-1206(18)30298-9 [pii]
LID - 10.1016/j.anai.2018.04.012 [doi]
AB  - BACKGROUND: The acquisition of food allergy (FA) to previously safely consumed 
      basic food proteins is an unusual presentation of immunoglobulin E (IgE)-mediated 
      allergic disease. OBJECTIVE: We sought to characterize patients who developed FA 
      to previously tolerated foods (FA-PTF), including underlying reasons for and 
      length of elimination diet of previously tolerated foods. METHODS: Patients 
      (n = 30) with complaints consistent with FA to foods previously consumed safely 
      were evaluated. Clinical history was obtained, and skin prick testing and graded 
      oral food challenges (OFC) were performed. One fatal case of FA-PTF was reported 
      by a physician. RESULTS: Twenty-two of 30 patients (ages 1.2-50 years) were 
      diagnosed with FA-PTF by OFC to milk (n = 17), egg (n = 2), and peanuts (n = 3). 
      One additional patient with FA-PTF had a fatal reaction to milk. Anaphylactic 
      reactions were reported in 12 of these 23 FA-PT patients (52%); 8 experienced 
      multiple episodes. Atopic dermatitis was diagnosed in 52% (12/23) of patients, 8 
      of 12 as severe; overall, 18 of 23 (78%) of patients had marked personal atopic 
      background. Sixteen patients (70%) initiated an elimination diet, 12 of whom did 
      so on advice from a health care provider, before the appearance of allergic 
      symptoms. However, in 4 patients with FA-PTF, reactivity to the food protein 
      emerged during uninterrupted consumption. CONCLUSION: Food allergy to previously 
      tolerated foods primarily appears after an elimination diet in atopic patients. 
      Anaphylactic reactions are common. Health care providers should consider these 
      risks before recommending elimination diet of tolerated foods.
CI  - Copyright (c) 2018 American College of Allergy, Asthma & Immunology. Published by 
      Elsevier Inc. All rights reserved.
FAU - Nachshon, Liat
AU  - Nachshon L
AD  - Allergy and Immunology Institute, Assaf-Harofeh Medical Center, Zerifin, Israel. 
      Electronic address: liatna2@gmail.com.
FAU - Goldberg, Michael R
AU  - Goldberg MR
AD  - Allergy and Immunology Institute, Assaf-Harofeh Medical Center, Zerifin, Israel.
FAU - Elizur, Arnon
AU  - Elizur A
AD  - Allergy and Immunology Institute, Assaf-Harofeh Medical Center, Zerifin, Israel; 
      Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel 
      Aviv, Israel.
FAU - Appel, Michael Y
AU  - Appel MY
AD  - Allergy and Immunology Institute, Assaf-Harofeh Medical Center, Zerifin, Israel.
FAU - Levy, Michael B
AU  - Levy MB
AD  - Allergy and Immunology Institute, Assaf-Harofeh Medical Center, Zerifin, Israel.
FAU - Katz, Yitzhak
AU  - Katz Y
AD  - Allergy and Immunology Institute, Assaf-Harofeh Medical Center, Zerifin, Israel; 
      Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel 
      Aviv, Israel.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20180421
PL  - United States
TA  - Ann Allergy Asthma Immunol
JT  - Annals of allergy, asthma & immunology : official publication of the American 
      College of Allergy, Asthma, & Immunology
JID - 9503580
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Anaphylaxis/etiology/*immunology/physiopathology
MH  - Child
MH  - Child, Preschool
MH  - Dermatitis, Atopic/*immunology/physiopathology
MH  - Diet/*adverse effects
MH  - Egg Hypersensitivity/etiology/*immunology/physiopathology
MH  - Female
MH  - Humans
MH  - Immunoglobulin E/blood
MH  - Infant
MH  - Male
MH  - Middle Aged
MH  - Milk Hypersensitivity/etiology/*immunology/physiopathology
MH  - Peanut Hypersensitivity/etiology/*immunology/physiopathology
MH  - Skin Tests
EDAT- 2018/04/24 06:00
MHDA- 2019/03/06 06:00
CRDT- 2018/04/24 06:00
PHST- 2017/10/20 00:00 [received]
PHST- 2018/04/13 00:00 [revised]
PHST- 2018/04/13 00:00 [accepted]
PHST- 2018/04/24 06:00 [pubmed]
PHST- 2019/03/06 06:00 [medline]
PHST- 2018/04/24 06:00 [entrez]
AID - S1081-1206(18)30298-9 [pii]
AID - 10.1016/j.anai.2018.04.012 [doi]
PST - ppublish
SO  - Ann Allergy Asthma Immunol. 2018 Jul;121(1):77-81.e1. doi: 
      10.1016/j.anai.2018.04.012. Epub 2018 Apr 21.