Investigation of clinical characteristics of children with food allergy and factors associated with tolerance development

Seda Çevik; Uğur Altaş; Zeynep Meva Altaş; Mehmet Yaşar Özkars; Seda Çevik; Uğur Altaş; Zeynep Meva Altaş; Mehmet Yaşar Özkars

doi:10.3934/Allergy.2025007

AIMS Allergy and Immunology

2025, Volume 9, Issue 2: 98-107. doi: 10.3934/Allergy.2025007

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Research article

Investigation of clinical characteristics of children with food allergy and factors associated with tolerance development

1.
Pediatric Allergy and Immunology Department, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
2.
Department of Public Health, Marmara University Faculty of Medicine, Istanbul, Turkey

Received: 13 November 2024 Revised: 07 May 2025 Accepted: 26 May 2025 Published: 31 May 2025

Objective: Food allergies, an immune reaction to food, affects 2–8% of children in developed countries, thereby presenting with symptoms ranging from anaphylaxis to gastrointestinal issues. This study explores the clinical and tolerance development aspects of pediatric food allergy cases at our clinic. Methods: This retrospective study included 187 pediatric patients with diagnosed food allergies from a pediatric allergy and immunology outpatient clinic at a training and research hospital. The patient files were retrospectively analyzed based on symptoms, improvements upon food removal from diets, food-specific IgE measurements, and skin prick tests. Results: This study included 187 pediatric patients diagnosed with food allergies, which were predominantly affected by eggs (66.8%) and cow's milk (54.5%). Tolerance developed in 73.3% of patients, with no significant differences based on age, gender, or comorbidities. Most patients with egg (72.8%) and milk (76.5%) allergies eventually developed a tolerance. While tolerance developed in 31.4% (n = 43) of patients with multiple allergies, tolerance developed in 68.6% (n = 94) of patients with an allergy to a single food. Conclusions: Our study of 187 pediatric patients highlighted egg and cow's milk as predominant allergens, with onsets typically in infancy. Tolerance developed in 73.3% of patients, with multiple allergies hindering tolerance acquisition. The median ages for tolerance were 12 months for cow's milk and 13 months for egg allergies, which indicates a relatively early resolution. The development of tolerance was found to be lower in patients with multiple food allergies than in patients with a single food allergy.
- cow milk,
- egg,
- food allergy,
- IgE-mediated,
- oral tolerance
Citation: Seda Çevik, Uğur Altaş, Zeynep Meva Altaş, Mehmet Yaşar Özkars. Investigation of clinical characteristics of children with food allergy and factors associated with tolerance development[J]. AIMS Allergy and Immunology, 2025, 9(2): 98-107. doi: 10.3934/Allergy.2025007

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Abstract

Objective: Food allergies, an immune reaction to food, affects 2–8% of children in developed countries, thereby presenting with symptoms ranging from anaphylaxis to gastrointestinal issues. This study explores the clinical and tolerance development aspects of pediatric food allergy cases at our clinic. Methods: This retrospective study included 187 pediatric patients with diagnosed food allergies from a pediatric allergy and immunology outpatient clinic at a training and research hospital. The patient files were retrospectively analyzed based on symptoms, improvements upon food removal from diets, food-specific IgE measurements, and skin prick tests. Results: This study included 187 pediatric patients diagnosed with food allergies, which were predominantly affected by eggs (66.8%) and cow's milk (54.5%). Tolerance developed in 73.3% of patients, with no significant differences based on age, gender, or comorbidities. Most patients with egg (72.8%) and milk (76.5%) allergies eventually developed a tolerance. While tolerance developed in 31.4% (n = 43) of patients with multiple allergies, tolerance developed in 68.6% (n = 94) of patients with an allergy to a single food. Conclusions: Our study of 187 pediatric patients highlighted egg and cow's milk as predominant allergens, with onsets typically in infancy. Tolerance developed in 73.3% of patients, with multiple allergies hindering tolerance acquisition. The median ages for tolerance were 12 months for cow's milk and 13 months for egg allergies, which indicates a relatively early resolution. The development of tolerance was found to be lower in patients with multiple food allergies than in patients with a single food allergy.

Conflict of interest

The authors declare that there is no conflict of interest in the preparation and publication of this article.

Author contributions

Conceptualization, S.Ç., M.Y.Ö. and U.A.; methodology, M.Y.Ö., Z.M.A., U.A.; validation, M.Y.Ö. and S.Ç.; formal analysis, S.Ç., U.A.; investigation, M.Y.Ö. and U.A.; resources, M.Y.Ö., S.Ç., and U.A.; data curation, S.Ç. and Z.M.A.; writing—original draft preparation, Z.M.A., S.Ç. and U.A.; writing—review and editing, M.Y.Ö. and S.Ç.; visualization, Z.M.A. and U.A.; supervision, M.Y.Ö and S.Ç. All authors have read and agreed to the published version of the manuscript.

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