Food allergy is associated with potentially fatal childhood asthma.
BACKGROUND
Risk factors for potentially fatal childhood asthma are incompletely understood.


OBJECTIVE
To determine whether self-reported food allergy is significantly associated with potentially fatal childhood asthma.


METHODS
Medical records from 72 patients admitted to a pediatric intensive care unit (PICU) for asthmatic exacerbation were reviewed and compared in a case-control design with 2 randomly selected groups of 108 patients admitted to a regular nursing floor for asthma and 108 ambulatory patients with asthma. Factors evaluated included self-reported food allergy, gender, age, poverty area residence, race/ethnicity, inhaled steroid exposure, tobacco exposure, length of hospital stay, psychologic comorbidity, and season of admission.


RESULTS
At least one food allergy was documented for 13% (38/288) of the patients. Egg, peanut, fish/shellfish, milk, and tree nut accounted for 78.6% of all food allergies. Children admitted to the PICU were significantly more likely to report food allergy (p = 0.004) and 3.3 times more likely to report at least one food allergy compared with children admitted to a regular nursing floor, and significantly more likely to report food allergy (p < 0.001) and 7.4 times more likely to report at least one food allergy compared with children seen in the ambulatory setting. Children admitted to either the PICU or the regular nursing floor were significantly more likely be African-American (p < 0.001) and to be younger (p < 0.01) compared with children seen in the ambulatory setting.


CONCLUSIONS
Self-reported food allergy is an independent risk factor for potentially fatal childhood asthma. Asthmatic children or adolescents with food allergy are a target population for more aggressive asthma management.
Vogel
Nicola M
NM
The Children's Hospital, The Cleveland Clinic Foundation, Center for Pediatric Allergy and Immunology, Cleveland, Ohio 44195, USA. nicolavogel@yahoo.com
Katz
Hary T
HT
Lopez
Rocio
R
Lang
David M
DM
D001249:Asthma / Q000209:etiology* / Q000401:mortality*; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors