Effect of atopic dermatitis on the natural course of food allergy in infants and young children

Ji Sun Park; Soon Jeong Moon; Dae Hyun Lim; Hae Ji Jang; Sun Young Hwang; Yoon Sung Park; Jeong Hee Kim

doi:10.4168/aard.2017.5.5.256

Journal List > Allergy Asthma Respir Dis > v.5(5) > 1059269

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Park, Moon, Lim, Jang, Hwang, Park, and Kim: Effect of atopic dermatitis on the natural course of food allergy in infants and young children

Original Article

Allergy Asthma Respir Dis 2017;5(5):256-261.

Published online: 5 September 2017

DOI: https://doi.org/10.4168/aard.2017.5.5.256

Effect of atopic dermatitis on the natural course of food allergy in infants and young children

Ji Sun Park¹, Soon Jeong Moon¹, Dae Hyun Lim^1,², Hae Ji Jang², Sun Young Hwang², Yoon Sung Park³, Jeong Hee Kim^1,²

¹Department of Pediatrics, Inha University Hospital, Incheon, Korea

²The Environmental Health Center for Allergic Rhinitis, Inha University Hospital, Incheon, Korea

³Research Institute for Healthcare Policy, Korean Medical Association, Seoul, Korea

Correspondence to: Jeong Hee Kim https://orcid.org/0000-0002-7054-8552 Department of Pediatrics, Inha University Hospital, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea Tel: +82-32-890-2843, Fax: +82-32-890-2844, E-mail: kimjhmd@inha.ac.kr

Received 13 March 201725 July 2017 Accepted 25 July 2017

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.

Abstract

Purpose

There have been studies showing that food allergy plays a role in the pathogenesis of atopic dermatitis. However, there have been few studies about the effect of atopic dermatitis on remission of food allergy. Thus, this study aimed to evaluate the difference in remission according to the presence of atopic dermatitis in infants and young children with milk or egg allergy.

Methods

A retrospective study was performed on 109 infants and young children with IgE-mediated food allergy in a tertiary hospital. They divided into food allergy with atopic dermatitis (FA with AD) and without atopic dermatitis (FA without AD).

Results

In the milk allergy group, initial milk-specific IgE levels were 21.16±27.98 kU A/L and 11.36±22.88 kU A/L, respectively, in FA with AD and FA without AD under 12 months of age. The remission rates of milk allergy at 36 months of age were 64.9% and 90.0%, respectively, in FA with AD and FA without AD. In the egg allergy groups, initial egg-specific IgE levels were 34.48±36.72 kU _A/L and 15.66±28.60 kU A/L, respectively, in FA with AD and FA without AD under 12 months of age. The remission rates of egg allergy at 36 months of age were 61.2% and 90.0% in children with FA with AD and FA without AD.

Conclusion

Atopic dermatitis may play an important role in the natural history of food allergy in infants. Different strategies are needed for the management of food allergy in young children with atopic dermatitis.

Keywords: Food hypersensitivity, Egg hypersensitivity, Milk hypersensitivity, Atopic dermatitis

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Fig. 1.

Subgroups of subjects. FA, food allergy, AD, atopic dermatitis.

Fig. 2.

Remission rate of milk allergy at 36 months of age. FA, food allergy; AD, atopic dermatitis.

Fig. 3.

Remission rate of egg allergy at 36 months of age. FA, food allergy; AD, atopic dermatitis.

Table 1.

Characteristics of subjects

Characteristic	FA with AD (n=57)	FA without AD (n=52)	P-value
Age that diagnosed with FA (mo)	9	10	0.91
Sex			0.74
Male	37	36
Female	20	16
Delivery type			0.46
Vaginal delivery	35	36
C-sec	22	16
Feeding under 3 month-aged
Breast milk	30	36	0.49
Artificial milk	27	16	0.37
History of sibling's FA	10	8	0.55
History of sibling's AD	16	4	0.36
History of parent's FA	5	2	0.33
History of parent's AD	8	3	0.40
Milk and egg allergy	30	5	<0.01∗

FA, food allergy; AD, atopic dermatitis; C-sec, Caesarean section.

^∗ P<0.05, statistically significant difference.

Table 2.

IgE level in infants and young children with milk allergy

IgE (kU _A/D)	FA with AD	FA without AD	P-value
Under 12 months (n=51)
Total IgE	374.60±352.74	159.41±247.55	0.001∗
Log (Total IgE)	5.39±1.13	3.90±1.66
Milk IgE	21.16±27.98	11.36±22.88	0.017∗
Log (Milk IgE)	2.14±1.53	0.83±2.14
12–23 Months (n=17)
Total IgE	330.60±316.81	131.30±179.60	0.119
Log (Total IgE)	5.29±1.21	4.19±1.21
Milk IgE	10.79±13.65	3.03±4.32	0.470
Log (Milk IgE)	1.06±2.29	0.28±1.49
24–35 Months (n=4)
Total IgE	150.90±110.44	72.64±22.96	0.206
Log (Total IgE)	4.86±0.81	4.26±0.32
Milk IgE	7.32±4.64	4.26±0.32	0.568
Log (Milk IgE)	1.88±0.68	-0.30±1.72

Values are presented as mean±standard deviation. FA, food allergy; AD, atopic dermatitis.

^∗ P<0.05, statistically significant difference.

Table 3.

IgE level in infants and young children with egg allergy

IgE (kU A/D)	FA with AD	FA without AD	P-value
Under 12 months (n=51)
Total IgE	325.00±326.02	159.41±247.55	0.001∗
Log (Total IgE)	5.18±1.26	3.51±1.44
Egg IgE	38.48±36.72	15.66±28.60	0.019∗
Log (Egg IgE)	3.00±1.34	0.99±2.27
12–23 Months (n=19)
Total IgE	218.60±262.43	175.40±184.99	0.965
Log (Total IgE)	4.76±1.20	4.82±0.83
Egg IgE	17.65±28.75	40.10±41.36	0.212
Log (Egg IgE)	2.06±1.28	2.99±1.40
24–35 Months (n=3)
Total IgE	499.00±0.00	100.40±62.27	0.283
Log (Total IgE)	6.21±0.00	4.50±0.66
Egg IgE	2.62±0.00	1.99±0.72	0.617
Log (Egg IgE)	0.96±0.00	0.62±0.37

Values are presented as mean±standard deviation.

FA, food allergy; AD, atopic dermatitis.

^∗ P<0.05, statistically significant difference.

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