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Published on: May 31, 2021
Food allergy is associated with potentially fatal childhood asthma
Nicola M Vogel1, Hary T Katz, Rocio Lopez
1The Children's Hospital, The Cleveland Clinic Foundation, Center for Pediatric Allergy and Immunology, Cleveland, Ohio 44195, USA. nicolavogel@yahoo.com
Insights
Self-reported food allergy is a significant risk factor for severe childhood asthma. Children with food allergies require more intensive asthma management to prevent potentially fatal exacerbations.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Public Health
Background:
- Potentially fatal childhood asthma risk factors are not fully understood.
- Identifying specific risk factors is crucial for effective asthma management in children.
- Food allergies are common in children and can impact respiratory health.
Purpose of the Study:
- To investigate the association between self-reported food allergy and potentially fatal childhood asthma.
- To determine if food allergy is an independent risk factor for severe asthma exacerbations requiring intensive care.
Main Methods:
- A case-control study comparing 72 pediatric intensive care unit (PICU) patients with asthmatic exacerbation to 108 regular floor and 108 ambulatory asthma patients.
- Data collected included self-reported food allergy, demographics, environmental exposures, and clinical factors.
- Statistical analysis was used to identify significant associations with severe asthma outcomes.
Main Results:
- 13% of patients reported at least one food allergy, with egg, peanut, fish/shellfish, milk, and tree nut being most common.
- PICU patients were significantly more likely to report food allergies (3.3x vs. regular floor, 7.4x vs. ambulatory).
- African-American race and younger age were also associated with more severe asthma admissions.
Conclusions:
- Self-reported food allergy is an independent risk factor for potentially fatal childhood asthma.
- Asthmatic children with food allergies represent a high-risk group needing proactive and aggressive management strategies.
- Early identification and tailored interventions for food-allergic asthmatic children can improve outcomes.
Background:
Risk factors for potentially fatal childhood asthma are incompletely understood.
Objective:
To determine whether self-reported food allergy is significantly associated with potentially fatal childhood asthma.
Study Design:
Medical records from 72 patients admitted to a pediatric intensive care unit (PICU) for asthmatic exacerbation were reviewed and compared in a case-control design with 2 randomly selected groups of 108 patients admitted to a regular nursing floor for asthma and 108 ambulatory patients with asthma. Factors evaluated included self-reported food allergy, gender, age, poverty area residence, race/ethnicity, inhaled steroid exposure, tobacco exposure, length of hospital stay, psychologic comorbidity, and season of admission.
Results:
At least one food allergy was documented for 13% (38/288) of the patients. Egg, peanut, fish/shellfish, milk, and tree nut accounted for 78.6% of all food allergies. Children admitted to the PICU were significantly more likely to report food allergy (p = 0.004) and 3.3 times more likely to report at least one food allergy compared with children admitted to a regular nursing floor, and significantly more likely to report food allergy (p < 0.001) and 7.4 times more likely to report at least one food allergy compared with children seen in the ambulatory setting. Children admitted to either the PICU or the regular nursing floor were significantly more likely be African-American (p < 0.001) and to be younger (p < 0.01) compared with children seen in the ambulatory setting.
Conclusions:
Self-reported food allergy is an independent risk factor for potentially fatal childhood asthma. Asthmatic children or adolescents with food allergy are a target population for more aggressive asthma management.
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