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Tree Nut Allergy, Egg Allergy,
and Asthma in Children
By Bogdan Cristina
Turcu Andrada
Borbely Iulia Adel
Group 4
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List of contents
Introduction
What is asthma?
Treatment
Background
Objective
Methods and materials
Results
Conclusion
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Children tend to beallergic to milk, eggs,wheat, and
peanuts,whereasadults primarily reactto peanuts, tree nuts,and seafood .
Asthma prevalence
has mirrored thisincrease, and it iscurrently estimatedthat 8.5% of childrensuffer from asthma.
For those with foodallergy, the prevalenceof asthma is as highas 29%.
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Symptoms of Food llergies andsthma
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What is asthma?
Asthma is a common chronic inflammatory disease of theairways characterized by variable and recurring symptoms,reversible airflow obstruction, and bronchospasm.Symptomsinclude wheezing, coughing, chest tightness, and shortnessof breath. Asthma is clinically classified according to thefrequency of symptoms, forced expiratory volume in 1
second (FEV1), and peak expiratory flow rate.Asthma mayalso be classified as atopic (extrinsic) or non-atopic(intrinsic).
Its diagnosis is usually made based on the pattern ofsymptoms and/or response to therapy over time. Theprevalence of asthma has increased significantly since the
1970s. As of 2010, 300 million people were affectedworldwide.In 2009 asthma caused 250,000 deaths globally.Despite this, with proper control of asthma with step downtherapy, prognosis is generally good.
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BackgroundChildren with foodallergies often haveconcurrent asthma.
Milk, egg, and wheatsensitization has been
associated with thedevelopment of asthma invery young children.However, clinicallyrelevant food allergy in
children spanning all agesand the relationship toasthma has been lesswell described.
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Objective
The aims of this study were to define the
prevalence of asthma in a large cohort of
children with food allergies and determine if
individual food allergies were specificallyassociated with asthma. We hypothesized
that there is a high prevalence of asthma in
the food-allergic population and that
individual food allergies differentiallyassociate with asthma risk.
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Methods
This study was a cross-sectional analysisof 799 children with skin prick test orspecific immunoglobulin E (sIgE)corroborating parental report of food allergyfrom a cohort of 1413 children withphysician-diagnosed food allergy. Afterobtaining written informed consent from thesubjects parent, a questionnaire regarding
the subjects food allergy history,environmental allergies, family history, anddemographics was distributed.
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Results
A total of 1522 questionnaires were
distributed among the 3 participating sites
to be filled out in waiting rooms or returned
by mail. Of the 1413 (93%) questionnairesreturned, 1330 (87%) subjects answered
the question regarding the presence of
asthma. Of these, 799 (60%) had skin prick
test or sIgE available to corroborate thereport of food allergy. Only these subjects
were included in the final analysis.
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Table 1.summarizes the distribution ofpredictor variables and covariates amongsubjects with and without report of asthma.For
each food allergy, after adjusting for thosewho had never tried the food, only childrenwith egg allergy and tree nut allergy hadsignificantly higher odds of having asthmathan those without the allergy. As expected,
several of the covariates were also positivelyand significantly associated with asthma, suchas hayfever, pet allergy, and family history ofallergic diseases. The risk of asthmaincreased sequentially by quartile of age
compared with the youngest quartile. Besidesthe effect of increasing age, hayfever and petallergy had the strongest associations withasthma. Univariate analysis of gender showedthat female gender was negatively associatedwith asthma.
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Figure 1.shows the prevalence of each
food allergy reported. Nearly half of the
subjects had never tried seafood, peanuts,
or sesame seeds, more than 60% hadnever tried tree nuts. When the never
tried group is removed from each food
allergy, there were more peanut-allergic
subjects than non-peanut-allergic subjects,and for tree nuts, the proportion of allergic
and not allergic subjects was nearly equal.
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Conclusion
There is a high prevalence ofasthma among the pediatricfood-allergic population. Wedemonstrate that egg andtree nut allergy, independent
of other food allergies, areassociated with asthma in alarge study of food-allergicchildren. These findingssuggest that clinicians should
have a low threshold tosuspect asthma in childrenwith food allergies, especiallyif the child is allergic to eggsor tree nuts.