Immunogloboulin E-Mediated Food Sensitization in Children with Celiac Disease: A Single-Center Experience
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Purpose: Celiac disease (CD) is an autoimmune disorder of the small intestine caused by an abnormal immune response to gluten proteins and is often characterized by gastrointestinal symptoms. Food allergy (FA) is an adverse immune sensitivity to ingested food proteins leading to inflammation in various organs including the gastrointestinal tract. The relationship between CD and FA remains unclear. This study aimed to assess the prevalence and clinical relevance of immunoglobulin E (IgE)-mediated food sensitization in children with CD. Methods: Fifty-nine children diagnosed with CD were reviewed for clinical symptoms and evidence of IgE-sensitization to food and airborne allergens using the PolyCheck method. Results: IgE-mediated sensitization has been diagnosed in 20.3% of children with CD (CD/ A). In the CD/A group, 58.3% of children were sensitized to food and 66.7% to airborne allergens. Further, 41.7% of patients with CD and allergy reported gastrointestinal tract symptoms associated with the ingestion of sensitizing foods. Analysis of the clinical status revealed that the incidence of other allergic disorders in the CD/A group was as follows: atopic dermatitis (33.3%), asthma (25.0%), and allergic rhinitis (16.7%). The percentage of eosinophils was significantly higher in the CD/A group than in the CD group (0.33±0.25 vs. 0.11±0.09; p=0.006). Conclusion: The diagnosis of CD does not exclude FA. The gastrointestinal symptoms in children with CD may be the result of both CD and FA; therefore, children with CD should be evaluated for the presence of FA regardless of age.
Abstract
Purpose: Celiac disease (CD) is an autoimmune disorder of the small intestine caused by an abnormal immune response to gluten proteins and is often characterized by gastrointestinal symptoms. Food allergy (FA) is an adverse immune sensitivity to ingested food proteins leading to inflammation in various organs including the gastrointestinal tract. The relationship between CD and FA remains unclear. This study aimed to assess the prevalence and clinical relevance of immunoglobulin E (IgE)-mediated food sensitization in children with CD. Methods: Fifty-nine children diagnosed with CD were reviewed for clinical symptoms and evidence of IgE-sensitization to food and airborne allergens using the PolyCheck method. Results: IgE-mediated sensitization has been diagnosed in 20.3% of children with CD (CD/ A). In the CD/A group, 58.3% of children were sensitized to food and 66.7% to airborne allergens. Further, 41.7% of patients with CD and allergy reported gastrointestinal tract symptoms associated with the ingestion of sensitizing foods. Analysis of the clinical status revealed that the incidence of other allergic disorders in the CD/A group was as follows: atopic dermatitis (33.3%), asthma (25.0%), and allergic rhinitis (16.7%). The percentage of eosinophils was significantly higher in the CD/A group than in the CD group (0.33±0.25 vs. 0.11±0.09; p=0.006). Conclusion: The diagnosis of CD does not exclude FA. The gastrointestinal symptoms in children with CD may be the result of both CD and FA; therefore, children with CD should be evaluated for the presence of FA regardless of age.
참고문헌 (28)
- Kårhus LL, "The association of celiac disease and allergic disease in a general adult population", United European Gastroenterol J, 7, pp.78~89 (2019)
- Ciacci C, "Allergy prevalence in adult celiac disease", J Allergy Clin Immunol, 113, pp.1199~1203 (2004)
- Lebwohl B, "Coeliac disease", Lancet, 391, pp.70~81 (2018)
- Peyman H, "Food allergy in patients with confirmed celiac disease", Clin Transl Allergy, 1(Suppl 1), pp.P27~ (2011)
- Bischoff SC, "Allergy and the gut", Int Arch Allergy Immunol, 121, pp.270~283 (2000)
- Daniluk U, "Longitudinal observation of children with enhanced total serum IgE", Ann Allergy Asthma Immunol, 114, pp.404~410.e4 (2015)
- Chibbar R, "The gut microbiota in celiac disease and probiotics", Nutrients, 11, pp.2375~ (2019)
- Nylund L, "The microbiota as a component of the celiac disease and non-celiac gluten sensitivity", Clin Nutr Exp, 6, pp.17~24 (2016)
- Pillon R, "Prevalence of celiac disease in patients with severe food allergy", Allergy, 70, pp.1346~1349 (2015)
- Wong T, "IgE-mediated allergy to wheat in a child with celiac disease-a case report", Allergy Asthma Clin Immunol, 10, pp.56~ (2014)
- Sánchez-García S, "Eosinophilic esophagitis, celiac disease, and immunoglobulin E-mediated allergy in a 2-year-old child", J Investig Allergol Clin Immunol, 21, pp.73~75 (2011)
- Morreale GC, "A difficult diagnosis of coeliac disease : repeat duodenal histology increases diagnostic yield in patients with concomitant causes of villous atrophy", Arab J Gastroenterol, 18, pp.241~244 (2017)
- Husby S, "Hepatology and Nutrition guidelines for diagnosing coeliac disease 2020", J Pediatr Gastroenterol Nutr, 70, pp.141~156 (2020)
- Syrigou E, "Soy allergy complicating disease management in a child with coeliac disease", Pediatr Allergy Immunol, 25, pp.826~828 (2014)
- Messina M, "Recent surveys on food allergy prevalence", Nutr Today, 55, pp.22~29 (2020)
- Kero J, "Could TH1 and TH2 diseases coexist? Evaluation of asthma incidence in children with coeliac disease, type 1 diabetes, or rheumatoid arthritis: a register study", J Allergy Clin Immunol, 108, pp.781~783 (2001)
- Khuhro AA, "Asthma and allergic rhinitis amongst children having celiac disease", Prof Med J, 26, pp.2151~2155 (2019)
- Enroth S, "Prevalence and sensitization of atopic allergy and coeliac disease in the Northern Sweden Population Health Study", Int J Circumpolar Health, 72(S2), pp.21403~ (2013)
- Caubet JC, "Non-IgE-mediated gastrointestinal food allergies in children", Pediatr Allergy Immunol, 28, pp.6~17 (2017)
- Nilsson N, "Wheat allergy in children evaluated with challenge and IgE antibodies to wheat components", Pediatr Allergy Immunol, 26, pp.119~125 (2015)
- Mennini M, "Anaphylaxis after wheat ingestion in a patient with coeliac disease : two kinds of reactions and the same culprit food", Eur J Gastroenterol Hepatol, 31, pp.893~895 (2019)
- Lifschitz C, "Cow's milk allergy : evidence-based diagnosis and management for the practitioner", Eur J Pediatr, 174, pp.141~150 (2015)
- Cabanillas B., "Gluten-related disorders: celiac disease, wheat allergy, and nonceliac gluten sensitivity", Crit Rev Food Sci Nutr, 60, pp.2606~2621 (2020)
- Nwaru BI, "Sheikh A Prevalence of common food allergies in Europe : a systematic review and meta-analysis", Allergy, 69, pp.992~1007 (2014)
- Valenti S, "Gluten-related disorders: certainties, questions and doubts", Ann Med, 49, pp.569~581 (2017)
- Ress K, "Celiac disease in children with atopic dermatitis", Pediatr Dermatol, 31, pp.483~488 (2014)
- Shalom G, "Atopic dermatitis and celiac disease: a cross-sectional study of 116,816 patients", Am J Clin Dermatol, 21, pp.133~138 (2020)
- Heffler E, "Chronic urticaria in a celiac patient : role of food allergy", J Investig Allergol Clin Immunol, 24, pp.356~357 (2014)