aard Allergy, Asthma & Respiratory Disease Allergy Asthma Respir Dis 2288-0402 2288-0410 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma 10.4168/aard.2018.6.4.219 aard-6-219 Original Article Etiology and clinical feature of oral allergy syndrome in children ParkYoung A 1 JeongKyung-Uk 2 KimYoon Hee 1 SolIn Suk 1 KimKyung Won 1 SohnMyung Hyun 1 LeeSoo Young 2 KimKyu-Earn 3 Department of Pediatrics and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea Department of Pediatrics, Ajou University College of Medicine, Suwon, Korea Sowha Children's Hospital, Seoul, Korea Correspondence to: Sooyoung Lee https://orcid.org/0000-0003-1734-4101 Department of Pediatrics, Ajou University School of Medicine, 206 World cup-ro, Yeongtong-gu, Suwon 16499, Korea Tel: +82-31-219-5164, Fax: +82-31-219-5169, E-mail: jsjs87@ajou.ac.kr Co-correspondence to: Myung Hyun Sohn https://orcid.org/0000-0002-2478-487X Department of Pediatrics and institute of allergy, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea Tel: +82-2-2228-2050, Fax: +82-2-393-9118, E-mail: MHSOHN@yuhs.ac

• This study was supported by the Outstanding Fellow Research Grant of the Korean Academy of Pediatric Allergy and Respiratory Disease

 72018 572018 64 219224 01122017 13042018 20042018 Copyright © 2018 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma 2018 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose

Oral allergy syndrome (OAS) is a unique allergic reaction to fresh fruits or vegetables, which is caused by cross-reactivity between foods and pollens. This study was conducted to investigate the clinical feature of OAS and relevant pollen allergens as well as the association between them in Korean children.

 Methods

This single-center study included 290 children who were sensitized to pollens at Severance Hospital, and the clinical characteristics of children with and without OAS were compared. A multicenter study included 97 children who were diagnosed with OAS at 3 hospitals between January 2008 and June 2014. The details of clinical features were collected by retrospective medical record reviews using a standardized case report form. The relevant pollen allergens were identified by skin prick tests and/or serum specific IgE levels.

 Results

The most commonly sensitized allergen was Japanese hop in pollen-sensitized children. Children with OAS were most commonly sensitized to birch and oak, and 12.4% of the pollen-sensitized children had OAS in the single center. The number of children who were newly diagnosed with OAS has increased over the past 7 years. The most common causative food of OAS was apple. More than 60% of patients with OAS had oral allergic reactions to multiple foods.

 Conclusion

OAS may be relatively common in pollen-sensitized children. OAS should be considered in children with allergic disease and sensitization to pollens.

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Distribution of allergic diseases in pollen-sensitized children (n=290) and distribution of combined other allergic diseases in children with oral allergy syndrome (n=36) in a single center.

Sensitization rates to pollen allergens. The most common sensitized allergens were Japanese hop followed by birch, oak, sagebrush in pollen-sensi-tized children (n=290). Birch and oak were the most commonly sensitized allergens in children with oral allergy syndrome (n=36) in a single center.

Yearly incidence of oral allergy syndrome showing an increasing tendency (n=97, multicenter study).

Comparison of children with or without oral allergy syndrome (OAS) in a single center (n=290)

Variable OAS (n=36, 12.4%) Non-OAS (n=254, 87.6%) P-value
Male sex 20 (55.6) 191 (75.2) 0.013
Age (yr) 10.06±3.10 10.20±2.77 0.454
Eosinophil count (/μL) 340 (275) 390 (380) 0.436
Serum total IgE (kU/L) 317 (421) 401 (666) 0.442
Asthma 14 (38.9) 104 (40.9) 0.814
Allergic rhinitis 24 (66.7) 201 (79.1) 0.093

Values are presented as number (%), mean±standard deviation, or median (interquartile range).

Food that caused oral allergy syndrome (n=97, multicenter study)

Causative food No. of patients (%)
Apple 59 (60.8)
Peach 34 (35.1)
Kiwi 26 (26.8)
Watermelon 17 (17.5)
Plum 11 (11.3)
Oriental melon 10 (10.3)
Pear 10 (10.3)
Melon 9 (9.3)
Banana 8 (8.2)
Cherry 8 (8.2)
Pineapple 8 (8.2)

Association between pollen and causative food in oral allergy syndrome (n=97, multicenter study)

Pollen Food No. of patients (%)
Birch (n=70) Apple 52 (74.3)
Peach 24 (34.3)
Kiwi 17 (24.3)
Plum 8 (11.4)
Ragweed (n=32) Watermelon 5 (15.6)
Grass (n=33) Oriental melon 5 (15.2)