Clinical and laboratory characteristics in children with oral allergy syndrome

Česká verzia

Authors: M. Repko ^1,2; B. Šoltýsová ²; M. Jeseňák ¹; Dáša Oppová ¹
Authors place of work: Klinika detí a dorastu, Jesseniova lekárska fakulta, Univerzita Komenského a Univerzitná nemocnica, Martin, Slovensko ¹; Pediatrické oddelenie s JIS, Nemocnica Poprad, a. s., Slovensko ²
Published in the journal: Čes-slov Pediat 2019; 74 (3): 168-174.
Category: Original Papers

Summary

Oral allergic syndrome (OAS) arises from cross-reactivity between homologous allergen components in plant foods and grass or tree pollen. It manifests with mild symptoms localized in the oropharyngeal region,
but anaphylaxis may occur rarely. In childhood, oral allergic syndrome is not explored as detailed as in adults. In our region, studies on these allergic diseases in childhood do not exist at all. The aim of our work was to investigate children with symptoms of oral allergic syndrome and to analyze its selected clinical and laboratory characteristics.

Methods: The set consisted of 55 children with OAS manifestations and was comprised of 2 groups: group A, in which from patients with seasonal allergic rhinitis were selected patients with OAS (25 patients) on the basis of a clinical evaluation. Group B consisted of 30 children with seasonal allergic reactions and OAS. Each patient completed anamnestic data and underwent blood sampling for the selection of selected markers of allergy (total IgE, eosinophils, component resolved diagnosis).

Results: The set consisted of 55 patients, 31 (56%) boys and 24 (44%) girls, median age 13 (3–18). OAS prevalence in Group A was 20.5%. The mean total IgE concentration was 470.7 IU/ml. Eosinophils were on average 5.43% in relative count, the average absolute count was 0.38 x 10⁹/l. From species-specific inhalation allergens, the most patients were sensitized to Bet v 1 allergen of birch (43, 78.2%) and Phl p 1 allergen of timothy grass (33, 60.0%). From the cross-allergen, the majority of patients were sensitized to allergens from the PR-10 protein family, Mald 1 apple allergen (34, 61.8%), peanut Ara h 8 allergen (30, 54.5%) and Cor and 1 hazelnut allergen (30, 54.5%). A total of 6 patients (10.9%) had a history of a systemic allergic reaction. All of these patients were sensitized with a type-specific risk food allergen.

Conclusion: The results of our observations are comparable to foreign studies with children with OAS from Central and Northern Europe. As the most common association within the OAS we prove the association birch-apple, peanuts and hazelnuts. Of the allergenic components, the majority of patients were sensitized with allergens from the PR-10 protein family.

Zdroje

1. Balková E. Ústny alergický syndróm. Klin Imunológia Alergológia 2013; 4: 13–18.

2. Ronchetti R, Kaczmarski MG, Haluzska J, et al. Food allergies, cross-reactions and agroalimentary biotechnologies. Adv Med Sci 2007; 52: 98–103.

3. Muluk NB, Cingi C. Oral allergy syndrome. Am J Rhinol Allergy 2018; 32: 27–30.

4. Popescu FD. Cross-reactivity between aeroallergens and food allergens. World J Methodol 2015; 5: 31–50.

5. Reindl J, Rihs HP, Scheurer S, et al. IgE reactivity to profilin in pollen-sensitized subjects with adverse reactions to banana and pineapple. Int Arch Allergy Immunol 2002; 128: 105–114.

6. Rodriguez J, Crespo JF, Lopez-Rubio A, et al. Clinical cross-reactivity among foods of the Rosaceae family. J Allergy Clin Immunol 2000; 106: 183–189.

7. Borres MP, Sato S, Ebisawa M. IgE-related examination in food allergy with focus on allergen components. Food Allergy Mol Basis Clin Pract 2015; 101: 68–78.

8. Repko M, Jeseňák M, Pohanka V. Orálny alergický syndróm v detskom veku. Pediatria (Bratisl) 2016; 11: 215–218.

9. Anhoej C, Backer V, Nolte H. Diagnostic evaluation of grass- and birch-allergic patients with oral allergy syndrome. Allergy 2001; 56: 548–552.

10. Skypala IJ, Calderon MA, Leeds AR, et al. Development and validation of a structured questionnaire for the diagnosis of oral allergy syndrome in subjects with seasonal allergic rhinitis during the UK birch pollen season. Clin Exp Allergy 2011; 41: 1001–1011.

11. Werfel T, Asero R, Ballmer-Weber BK, et al. Position paper of the EAACI: food allergy due to immunological cross-reactions with common inhalant allergens. Allergy 2015; 70: 1079–1090.

12. Wang J. Oral allergy syndrome. In: Pediatric Allergy, Principles and Practice. Elsevier, 2015: 1–568.

13. Balková E. Orálny alergický syndróm (peľovo-potravinový syndróm) u pacientov alergických na peľ brezy. Alergie 2014; 16: 240–244.

14. Cudowska B, Kaczmarski M, Wasilewska J. Cross allergic reactions in infants and toddlers with atopic dermatitis. Adv Med Sci 2013; 58: 401–407.

15. Ivković-Jureković I. Oral allergy syndrome in children. Int Dent J 2015; 65: 164–168.

16. Ludman S, Jafari-Mamaghani M, Ebling R, et al. Pollen food syndrome amongst children with seasonal allergic rhinitis attending allergy clinic. Pediatr Allergy Immunol 2016; 27: 134–140.

17. Bedolla-Barajas M, Kestler-Gramajo A, Alcalá-Padilla G, Morales-Romero J. Prevalence of oral allergy syndrome in children with allergic diseases. Allergol Immunopathol (Madr) 2017; 45 (2): 127–133.

18. Mastrorilli C, Tripodi S, Caffarelli C, et al. Endotypes of pollen-food syndrome in children with seasonal allergic rhinoconjunctivitis: a molecular classification. Allergy 2016; 71: 1181–1191.

19. Azamar-Jácome AA, Azamar-Jácome MA, Borjas-Aguilar KL, et al. Clinical-epidemiological profile of oral allergy syndrome in the population aged 6 to 18 years. Rev Alerg Mex (Tecamachalco Puebla Mex) 1993 2017; 64: 142–152.

20. Matricardi PM, Kleine-Tebbe J, Hoffmann HJ, et al. EAACI Molecular Allergology User’s Guide. Pediatr Allergy Immunol 2016; 27: 1–250.

21. Sicherer SH, Simons FER, AAP Section on Allergy and Immunology. Epinephrine for first-aid management of anaphylaxis. Pediatrics 2017; e20164006.

22. Jeseňák M, Havlíčeková Z, Buchanec J, et al. Diagnostický algoritmus potravinovej alergie v detskom veku. Čes-slov Pediat 2008; 63: 272–282.