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Accidental Allergic Reactions to Immediate-Type Food Allergens in Japanese Children: A Single-Center Study
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  • Noriyuki Yanagida,
  • Yoko Miura,
  • Ken-ichi Nagakura,
  • Kyohei Takahashi,
  • Sakura Sato,
  • Motohiro Ebisawa
Noriyuki Yanagida
Kokuritsu Byoin Kiko Sagamihara Byoin

Corresponding Author:[email protected]

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Yoko Miura
Kokuritsu Byoin Kiko Sagamihara Byoin
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Ken-ichi Nagakura
Kokuritsu Byoin Kiko Sagamihara Byoin
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Kyohei Takahashi
Kokuritsu Byoin Kiko Sagamihara Byoin
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Sakura Sato
Kokuritsu Byoin Kiko Sagamihara Byoin
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Motohiro Ebisawa
Kokuritsu Byoin Kiko Sagamihara Byoin
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Abstract

Background: Accidental allergic reactions (AAR) in children are under-studied, especially with precise pediatrician-based exact diagnoses and follow-ups. This study aimed to assess the prevalence and risk factors for AAR in Japanese children with immediate-type food allergies. Methods: This single-center study included children with immediate-type hen’s egg (HE), cow’s milk (CM), wheat, or peanut allergy who had been followed-up regularly at a national center specialized for allergy in Japan. Low-dose reactivity was defined as allergic reactions to a low dose of ≤250, ≤102, ≤53, or ≤133 mg HE, CM, wheat, or peanut protein, respectively. From January to December 2020, pediatricians followed the AAR experience every 2–4 months. Risk factors for AAR were analyzed using multiple logistic regression. Results: Of the 1096 participants, 609, 457, 138, and 90 had HE, CM, wheat, and peanut allergies, respectively. In this cohort, the median age was 5.0 years, 39% had completely eliminated allergenic food, and 24% had low-dose reactivity. The annual AAR rate was 0.130 in all sub-cohorts. Moderate and severe symptoms occurred in 50% and 0.7%, respectively, of children who experienced AAR. Multiple logistic regression revealed that low-dose reactivity was a significant risk factor for AAR in the overall, HE, and CM cohorts, respectively ( p <0.001, p = 0.029 and 0.036). Conclusion: In Japanese children with immediate-type food allergies, the annualized rate of AAR was relatively low; however, half of the participants with AAR had moderate to severe symptoms. Children, especially those with low-dose reactivity, would require careful risk management of AAR.
20 Oct 2023Submitted to Pediatric Allergy and Immunology
20 Oct 2023Assigned to Editor
20 Oct 2023Submission Checks Completed
20 Oct 2023Review(s) Completed, Editorial Evaluation Pending
26 Oct 2023Reviewer(s) Assigned
10 Nov 2023Editorial Decision: Revise Major