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Birch pollen-related foods can cause late eczematousreactions in patie…

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댓글 0건 조회 1,287회 작성일 19-03-21 19:20

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Birch pollen-related foods can cause late eczematous
reactions in patients with atopic dermatitis
Birch pollen-related foods can cause late eczematousreactions in patients with atopic dermatitis
A. Wassmann-Otto, A. Heratizadeh, K. Wichmann
(Allergy.2018;73:2046–2054)<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

Background:Previous studies have indicated that in patients with atopic dermatitis(AD) and birch pollen allergy pollen-related foods are able to cause late eczematousresponse. However, the relevance of AD worsening by ingestion of birch pollen-related foods is still a matter of debate.
Objective:The purpose of this retrospective study was to determine how fre-quently birch pollen-related foods induce a deterioration of eczema. Additionally,the diagnostic value of specific IgE (sIgE) determination was evaluated.
Methods:A total of 182 children and adults with AD and suspected birch pollen-related food allergy underwent 261 double-blind placebo-controlled food challenges(DBPCFC). Total and sIgE levels were determined prior to DBPCFC.
Results:Sixty-five patients developed allergic reactions (responders) upon DBPCFCwith birch pollen-related foods (n=103 DBPCFC). Of these, 32 patients exhibitedsignificant deterioration of AD defined as a median increase of 15.4 severity scoringof atopic dermatitis index points (95% CI 12.4-16.3) from baseline making up 37%of all positive reactions. Responders showed significantly higher sIgE levels to birchpollen and apple as well as a higher prevalence of allergic rhinoconjunctivitis com-pared to nonresponders (P<.05). However, patients with late eczematous responsecould not be differentiated from those with isolated immediate-type reactions bysIgE levels.
Conclusion:In a subpopulation of patients with AD and birch pollen sensitization,related foods should be considered as a trigger for an aggravation of eczema. A ssufficient markers for prediction of late eczematous reactions are still lacking,DBPCFC cannot be replaced in diagnosis of birch pollen-related foods in patientswith AD.
Clinical implications:In patients with AD and birch pollen allergy, birch pollen-related foods should be considered as a provocation factor for an aggravation ofdisease signs and symptoms.

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