Deakin University

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Confirmation of the association between high levels of immunoglobulin E food sensitization and eczema in infancy: An international study

journal contribution
posted on 2008-01-01, 00:00 authored by D J Hill, C S Hosking, F M De Benedictis, A P Oranje, T L Diepgen, V Bauchau, J O Warner, C K Naspitz, F E R Simons, U Wahn, E Von Mutius, C Grüber, D Hill, F Rancé, M Wajskop, M De Longueville, C Fortpied, M E Pinelli, F Staelens, M Gold, P Quinn, H Marshall, M Kummerow, R Heine, D Bannister, Peter Sly, R Loh, A Halbert, T Douglas, S Stick, P Van Asperen, A Kakakios, W Nightingale, K Mckay, M Zach, A Pfleger, E M Varga, W Emminger, B Käfer, D Stefanovic, V Plank, A De Moor, K Desager, M Hagendorens, L De Raeve, A Malfoort, O Rybníček, J Chládkov́a, T Chyba, F Kopřiva, O Škopková, V Balcárek, H Honomichlova, P Honomichlová-Houdkova, P Honomichl, V Petru, A Carbolova, K Kopecká, P Pohunek, T Svobodova, V Špičák, M Maltulka, M Špiřáková, S Kynclova, E Billard, M Robert, H Cartier, M C Castelain, F Payot, J Levy, M Ruer, F Cambazard, J L Perrot, L Fond, M Pétrus, G Le Manach, J Robert, F Friedrichs, C Pfannenstiel, S Jobst, H Schatz, B Niggemann, H G Bresser, K Landwehr, U Schauer, T Zimmermann, M Hertl, T Froehlich-Krapf, D Bulle, E Rietschel, L Lange, S Müller
Background: Studies of Australian infants have reported that more than 80% of those with moderate atopic eczema (AE) have high levels of IgE food sensitization (IgE-FS) that are commonly associated with IgE food allergy. Objectives: To explore the relationship between high levels of IgE-FS and AE in a large cohort of young children with eczema participating in a multi-centre, international study. Methods: Two thousand one hundred and eighty-four subjects (mean age 17.6 months, range 11.8-25.4; 1246 males) with active eczema from atopic families from 94 centres in 12 countries were studied. Clinical history, Scoring Atopic Dermatitis index as a measure of eczema severity and CAP-FEIA measurements for total IgE and IgE antibody levels to cow milk, egg and peanut were entered into a database. If CAP-FEIA levels exceeded previously reported age-specific cut-off levels for 95% positive predictive values (PPVs) for food allergy, subjects were defined as having high-risk IgE-FS (HR-IgE-FS). Results: Serum was available from 2048 patients; 55.5% were atopic. The frequency of HR-IgE-FS to milk, egg and/or peanut was the greatest in patients whose eczema developed in the first 3 months of life and the least in those whose eczema developed after 12 months (P<0.0001). In a regression analysis to allow for potential confounding factors, children with HR-IgE-FS had the most severe eczema and the youngest age of onset (P<0.001); 64% of infants with severe eczema of onset-age <3 months had HR-IgE-FS. Conclusion: Early-onset severe eczema in infancy was associated with HR-IgE-FS. Clinical implications: Food allergies should be routinely assessed in infants with moderate or severe eczema. Capsule summary: In eczematous infants, the earlier the age of onset, and the greater the severity of eczema, the greater the frequency of associated high levels of IgE-FS. © 2007 Blackwell Publishing Ltd.



Clinical and Experimental Allergy






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