Response of specific immunoglobulin E to foods in children with atopic dermatitis

Food allergy is a common condition that plays an important role in the pathogenicity and maintenance of atopic dermatitis (AD), however, must be carefully investigated before imposing a restrictive diet. The aim of this study was to evaluate the sensitivity to foods in patients with AD, correlating it with the severity of the disease and other possible associated factors. One hundred and eleven children (6-180 months of age) with AD were evaluated and later followed up at the Allergy and Clinical Immunology Division, Department of Pediatrics at FMABC. The serum concentrations of specific IgE to cow's milk (CM), egg, soy, wheat, corn, peanut and fish were measured using an enzymatic fluorescence method (ImmunoCAP™). In order to identify the clinical reactivity, the open oral provocation test was performed when specific IgE was positive to CM, egg and wheat and in all those who related symptoms after the intake of such foods regardless of the presence or absence of sensitization. In total, 40.5 % of the studied population was sensitized to at least one food allergen, especially those between 73 and 180 months of age. There was a higher prevalence of sensitization in children with more severe AD, and foods like CM, egg and wheat were the most involved, but with low clinical reactivity. We observed increased severity of AD in cases that initiated symptoms earlier and who had shorter duration of exclusive breastfeeding as well as a linear increase in sensitization in the most serious cases. Serum-specific immunoglobulin E was the only factor associated with the relationship that showed sensitization. The occurrence of sensitization to foods was frequent, mainly in the age group of 6-9 years and in patients with severe AD; however, the validation of the clinical reactivity was negative in most of the provocations performed, which agrees with the need to prove the same before the imposition of restrictive diets, often unnecessary and complex.