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Evidence summaries

Respiratory Symptoms of Food Allergy

Respiratory symptoms may be more rare in food allergy than cutaneous or gastrointestinal symptoms. Level of evidence: "C"

In studies the incidence of respiratory symptoms is usually indicated as a single figure - and rhinitis, dyspnoea and asthmatic symptoms have not been defined separately.

In the follow-up study by Høst 11,749 children were monitored and the prevalence of respiratory symptoms in food challenge testing was less than 10 %. In the study by Schrander, 4 % of children developed rhinitis, 19 % a cough and 12 % wheezing 2, whereas in the Finnish study cohort of Saarinen 36 % manifested respiratory symptoms during challenge testing 3.

Sampson et al. carried out a prospective study on a cohort of 320 children and adolescents extending back over 11 years, whose presenting symptom was atopic eczema 4. The cohort population was highly select with, for example, the median IgE concentration being 3,400 IU/l. Forty-five per cent had asthma in addition to atopic eczema. The age distribution was weighted towards the pre-school age, the median age being 4.4 years. A food challenge was carried out in a total of 205 children (monitored for immediate reactions) and 121 (59 %) experienced respiratory reactions; 17 % developed nasal, laryngeal or pulmonary symptoms.

    References

    • Høst A, Halken S. A prospective study of cowmilk allergy in Danish infants during the first 3 years of life. Clinical course in relation to clinical and immunological type of hypersensitivity reaction. Allergy 1990 Nov;45(8):587-96. [PubMed]
    • Schrander JJ, van den Bogart JP, Forget PP, Schrander-Stumpel CT, Kuijten RH, Kester AD. Cow's milk proteinintolerance in infants under 1 year of age: a prospective epidemiological study. Eur J Pediatr 1993 Aug;152(8):640-4. [PubMed]
    • Saarinen KM, Juntunen-Backman K, Järvenpää AL, Kuitunen P, Lope L, Renlund M, Siivola M, Savilahti E. Supplementary feeding in maternity hospitals and the risk of cow's milk allergy: A prospective study of 6209 infants. J Allergy Clin Immunol 1999 Aug;104(2 Pt 1):457-61. [PubMed]
    • James JM, Bernhisel-Broadbent J, Sampson HA. Respiratory reactions provoked by double-blind food challenges in children. Am J Respir Crit Care Med 1994 Jan;149(1):59-64. [PubMed]

Primary/Secondary Keywords