Food allergy and asthma morbidity in children.
BACKGROUND
Coexisting food allergy and asthma is a significant problem in the pediatric population. Studies have looked at the association between food sensitization and asthma severity. It is unknown whether specific food allergies are associated with increased asthma morbidity.


OBJECTIVE
We studied the independent effect that allergy to egg, milk, fish, and peanut has on the number of hospitalizations and courses of systemic steroids in children with asthma.


METHODS
We performed a medical record review to evaluate the effect food allergy to egg, fish, peanut, and milk has on asthma morbidity. We reviewed the records of 201 children aged 3 months to 14 years with the diagnosis of asthma (ICD-9 codes 493.90, 493.91, and 493.92), of which 88 had coexistent food allergy. All children in the food allergy group had food-specific IgE concentrations greater than the 95% positive predictive value. We compared the rate of hospitalizations and use of systemic steroids between children with asthma and food allergies and those without coexisting food allergy using direct-entry, multiple regression analysis. Patients were adjusted for the severity of their asthma based on symptoms documented at their first visit to the allergist according to the National Asthma Education and Prevention Program guidelines and presence of environmental allergy, eczema, smoke exposure, and gastroesophageal reflux.


RESULTS
Peanut and milk allergies were both associated with increased number of hospitalizations (P=0.009, 0.016), and milk allergy was associated with increased use of systemic steroids (P=0.001).


CONCLUSIONS
Peanut and milk allergies were associated with increased hospitalization and steroid use and may serve as early markers for increased asthma morbidity.
Simpson
Alyson B
AB
Division of Allergy and Immunology, Alfred I. duPont Hospital for Children, Nemours Children's Clinic, Wilmington, Delaware 19803, USA.
Glutting
Joe
J
Yousef
Ejaz
E
D000293:Adolescent; D001249:Asthma / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D021181:Egg Hypersensitivity / Q000150:complications / Q000276:immunology; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology; D006760:Hospitalization / Q000639:trends; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology / Q000502:physiology; D007223:Infant; D008297:Male; D016269:Milk Hypersensitivity / Q000150:complications / Q000276:immunology; D009017:Morbidity; D021183:Peanut Hypersensitivity / Q000150:complications / Q000276:immunology; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013256:Steroids / Q000627:therapeutic use
D013256:Steroids; D007073:Immunoglobulin E