Which infants with eczema are at risk of food allergy? Results from a population-based cohort

Martin, P. E., Eckert, J. K., Koplin, J. J., Lowe, A. J., Gurrin, L. C., Dharmage, S. C., Vuillermin, P., Tang, M. L., Ponsonby, A. L., Matheson, M., Hill, D. J. and Allen, K. J. 2015, Which infants with eczema are at risk of food allergy? Results from a population-based cohort, Clinical & experimental allergy, vol. 45, no. 1, pp. 255-264, doi: 10.1111/cea.12406.

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Title Which infants with eczema are at risk of food allergy? Results from a population-based cohort
Author(s) Martin, P. E.
Eckert, J. K.
Koplin, J. J.
Lowe, A. J.
Gurrin, L. C.
Dharmage, S. C.
Vuillermin, P.
Tang, M. L.
Ponsonby, A. L.
Matheson, M.
Hill, D. J.
Allen, K. J.
Journal name Clinical & experimental allergy
Volume number 45
Issue number 1
Start page 255
End page 264
Total pages 10
Publisher Wiley
Place of publication London, Eng.
Publication date 2015-01
ISSN 1365-2222
Keyword(s) eczema
egg allergy
food allergy
peanut allergy
population-based cohort
risk factors
HealthNuts Study Investigators
Science & Technology
Life Sciences & Biomedicine
Summary BACKGROUND: The relationship between early onset eczema and food allergy among infants has never been examined in a population-based sample using the gold standard for diagnosis, oral food challenge. OBJECTIVE: We characterised the risk of challenge-proven food allergy among infants with eczema in the general population. METHODS: One-year-old infants (n = 4453 meeting criteria for this analysis) were assessed for history of eczema, received a nurse-administered eczema examination and underwent skin prick testing to peanut, egg and sesame. Those with a detectable wheal to one of the test foods underwent an oral food challenge irrespective of wheal size. The risk of food allergy, stratified by eczema severity and age of onset, was estimated using multivariate logistic regression with population sampling weights. RESULTS: One in five infants with eczema were allergic to peanut, egg white or sesame, compared to one in twenty-five infants without eczema (OR 6.2, 95% CI 4.9, 7.9, P < 0.001). The prevalence of peanut allergy was low in the absence of eczema (0.7% 95% CI 0.4, 1.1). Infants with eczema were 11.0 times more likely to develop peanut allergy (95% CI 6.6, 18.6) and 5.8 times more likely to develop egg allergy (95% CI 4.6, 7.4) by 12 months than infants without eczema. 50.8% of infants (95% CI 42.8, 58.9) with early eczema onset (<3 months) who required doctor-prescribed topical corticosteroid treatment developed challenge-proven food allergy. CONCLUSION AND CLINICAL RELEVANCE: Eczema, across the clinical severity spectrum in infancy, is a strong risk factor for IgE-mediated food allergy. Infants with eczema were six times more likely to have egg allergy and 11 times more likely to have peanut allergy by 12 months than infants without eczema. Our data suggest that a heightened awareness of food allergy risk among healthcare practitioners treating infants with eczema, especially if early onset and severe, is warranted.
Language eng
DOI 10.1111/cea.12406
Field of Research 111403 Paediatrics
Socio Economic Objective 920501 Child Health
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2015, Wiley
Persistent URL http://hdl.handle.net/10536/DRO/DU:30077482

Document type: Journal Article
Collection: School of Medicine
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