IgE-Mediated Food Allergy in Patients with Celiac Disease

Celiac disease (CD) is an immune-mediated enteropathy triggered by gluten in genetically predisposed individuals. While CD is associated with various autoimmune and allergic conditions, the prevalence of IgE-mediated food allergies among CD patients remains underexplored. This study aimed to investigate the prevalence of specific IgE-mediated food allergies in individuals with CD and to assess associated clinical features.

This retrospective observational study utilized anonymized electronic health record (EHR) data from Leumit Health Services (LHS), a nationwide healthcare provider in Israel. Adult patients with a documented diagnosis of CD (ICD-9 code 579.0) were identified. A control group was randomly selected at a 1:10 ratio, matched for age category, sex, geographic region, ethnic background, and socioeconomic status. The prevalence of physician-diagnosed IgE-mediated food allergies and related clinical outcomes was compared between groups.

The study included 3,389 CD patients and 33,890 matched controls. The mean age was 18 years; 64% were female. The cumulative incidence of IgE-mediated food allergies was significantly higher in CD patients (4.75%) than in controls (2.25%), with an odds ratio (OR) of 2.16 (95% CI: 1.82-2.57, p < 0.001). Milk allergy was most common (1.95% vs. 1.25%, OR 1.56, 95% CI: 1.18-2.04). CD patients had significantly increased odds of allergies to eggs (OR 4.01), peanuts (OR 4.29), tree nuts (OR 3.34), and food-related dermatitis (OR 3.68). Anaphylaxis rates were higher but not statistically significant.

CD is associated with an increased risk of IgE-mediated food allergies. Further studies are warranted to elucidate the immunopathological links and clinical implications of this association.