IgE mediated legume allergy in east Mediterranean children: A reflection of multiple food allergies. Issue 4 (18th April 2022)

• Record Type: Journal Article
• Authors: Soyak Aytekin, Elif; Unsal, Hilal; Sahiner, Umit Murat; Soyer, Ozge; Sekerel, Bulent Enis
• Is Part Of: Pediatric allergy and immunology. Volume 33:Issue 4(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-04-18
• Subjects: bean -- chickpea -- legume allergy -- lentil -- Mediterranean region -- pea -- peanut; Allergy in children -- Periodicals; Immunologic diseases in children -- Periodicals; 617
• DOI: 10.1111/pai.13775
• Languages: English
• ISSNs: 0905-6157

Abstract

Abstract: Background: Legumes are nutritionally valuable as an inexpensive protein source, but may cause severe allergic reactions. This study aimed to identify the characteristics of legume allergies (LAs) in Turkish children. Methods: A total of 87 children (4.9 (3.1–7.0) years) with LAs confirmed by either oral food challenge (OFC) or consistent history were reviewed. Results: The median age of onset was 19 (12–38) months. The most frequent LA was lentil ( n = 57, 66%), followed by peanut ( n = 53, 61%), chickpea ( n = 24, 28%), pea ( n = 21, 24%), bean ( n = 7, 8%), and soybean ( n = 1, 1%). From these, it was observed that 60% had multilegume (≥2) allergies and the age of onset occurred earlier compared with the single LA subgroup (18 (11–30) vs. 28 (17–42) months, p = .042). Single LA was present in peanut (51%) and lentil (16%) allergies, but not chickpea, pea, and bean. Fifteen patients had tolerated lentils before their first allergic reaction. The majority of children with LA (91.9%) were allergic to multiple foods including tree nuts (71%), hen's egg (66%), and cow's milk (49%). Seventy‐eight patients (89.7%) also presented with atopic comorbidities concerning atopic dermatitis (70%), asthma (40%), and allergic rhinitis (30%). Patients with anaphylactic type of reaction (20%) had higher frequency of aeroallergen sensitization ( p = .001). Lip dose challenge with legume paste predicted the result of OFC with a diagnostic accuracy of 81.82% and a positive likelihood ratio of 10.8. Conclusion: In Turkey, LA is a reflection of multiple food allergies and the presence of allergy to a least frequently encountered legume is a sign of multiple LA.