Tree Nut Allergy, Egg Allergy, And

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    Tree Nut Allergy, Egg Allergy,

    and Asthma in Children

    By Bogdan Cristina

    Turcu Andrada

    Borbely Iulia Adel

    Group 4

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    List of contents

    Introduction

    What is asthma?

    Treatment

    Background

    Objective

    Methods and materials

    Results

    Conclusion

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    Children tend to beallergic to milk, eggs,wheat, and

    peanuts,whereasadults primarily reactto peanuts, tree nuts,and seafood .

    Asthma prevalence

    has mirrored thisincrease, and it iscurrently estimatedthat 8.5% of childrensuffer from asthma.

    For those with foodallergy, the prevalenceof asthma is as highas 29%.

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    Symptoms of Food llergies andsthma

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    What is asthma?

    Asthma is a common chronic inflammatory disease of theairways characterized by variable and recurring symptoms,reversible airflow obstruction, and bronchospasm.Symptomsinclude wheezing, coughing, chest tightness, and shortnessof breath. Asthma is clinically classified according to thefrequency of symptoms, forced expiratory volume in 1

    second (FEV1), and peak expiratory flow rate.Asthma mayalso be classified as atopic (extrinsic) or non-atopic(intrinsic).

    Its diagnosis is usually made based on the pattern ofsymptoms and/or response to therapy over time. Theprevalence of asthma has increased significantly since the

    1970s. As of 2010, 300 million people were affectedworldwide.In 2009 asthma caused 250,000 deaths globally.Despite this, with proper control of asthma with step downtherapy, prognosis is generally good.

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    BackgroundChildren with foodallergies often haveconcurrent asthma.

    Milk, egg, and wheatsensitization has been

    associated with thedevelopment of asthma invery young children.However, clinicallyrelevant food allergy in

    children spanning all agesand the relationship toasthma has been lesswell described.

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    Objective

    The aims of this study were to define the

    prevalence of asthma in a large cohort of

    children with food allergies and determine if

    individual food allergies were specificallyassociated with asthma. We hypothesized

    that there is a high prevalence of asthma in

    the food-allergic population and that

    individual food allergies differentiallyassociate with asthma risk.

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    Methods

    This study was a cross-sectional analysisof 799 children with skin prick test orspecific immunoglobulin E (sIgE)corroborating parental report of food allergyfrom a cohort of 1413 children withphysician-diagnosed food allergy. Afterobtaining written informed consent from thesubjects parent, a questionnaire regarding

    the subjects food allergy history,environmental allergies, family history, anddemographics was distributed.

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    Results

    A total of 1522 questionnaires were

    distributed among the 3 participating sites

    to be filled out in waiting rooms or returned

    by mail. Of the 1413 (93%) questionnairesreturned, 1330 (87%) subjects answered

    the question regarding the presence of

    asthma. Of these, 799 (60%) had skin prick

    test or sIgE available to corroborate thereport of food allergy. Only these subjects

    were included in the final analysis.

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    Table 1.summarizes the distribution ofpredictor variables and covariates amongsubjects with and without report of asthma.For

    each food allergy, after adjusting for thosewho had never tried the food, only childrenwith egg allergy and tree nut allergy hadsignificantly higher odds of having asthmathan those without the allergy. As expected,

    several of the covariates were also positivelyand significantly associated with asthma, suchas hayfever, pet allergy, and family history ofallergic diseases. The risk of asthmaincreased sequentially by quartile of age

    compared with the youngest quartile. Besidesthe effect of increasing age, hayfever and petallergy had the strongest associations withasthma. Univariate analysis of gender showedthat female gender was negatively associatedwith asthma.

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    Figure 1.shows the prevalence of each

    food allergy reported. Nearly half of the

    subjects had never tried seafood, peanuts,

    or sesame seeds, more than 60% hadnever tried tree nuts. When the never

    tried group is removed from each food

    allergy, there were more peanut-allergic

    subjects than non-peanut-allergic subjects,and for tree nuts, the proportion of allergic

    and not allergic subjects was nearly equal.

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    Conclusion

    There is a high prevalence ofasthma among the pediatricfood-allergic population. Wedemonstrate that egg andtree nut allergy, independent

    of other food allergies, areassociated with asthma in alarge study of food-allergicchildren. These findingssuggest that clinicians should

    have a low threshold tosuspect asthma in childrenwith food allergies, especiallyif the child is allergic to eggsor tree nuts.