title: Causes of food-induced anaphylaxis in Italian adults: a multi-centre study.
abstract: BACKGROUND
  Data about food-induced anaphylaxis in Italy are missing.
  
  
  OBJECTIVE
  It was the aim of this study to detect the main foods/food allergens causing anaphylaxis in Italy.
  
  
  METHODS
  The frequency of anaphylaxis and the relative importance of many offending foods were assessed in 1,110 adult patients with food allergy diagnosed by common criteria at 19 allergy centres scattered throughout Italy from 1 January to 31 December 2007.
  
  
  RESULTS
  Fifty-eight of 1,110 (5%) food-allergic patients experienced at least 1 episode of anaphylaxis. On average, they were older than other food-allergic patients (34 vs. 31 years; p < 0.05). The majority of anaphylactic episodes occurred in patients sensitized to lipid transfer protein (LTP; n = 19), followed by shrimp (n = 10), tree nuts (n = 9), legumes other than peanut (n = 4), and seeds (n = 2); peanut, spinach, celery, buckwheat, wheat, avocado, tomato, fish, meat, and Anisakis caused an anaphylactic reaction in single patients. Among LTP-hypersensitive patients, peach caused 13/19 anaphylactic episodes. Shrimp-allergic patients were significantly older than other patients with food-induced anaphylaxis (p < 0.05), whereas patients allergic to LTP experienced their anaphylactic episodes at a younger age (p < 0.001). The frequency of anaphylaxis among patients sensitized to LTP, shrimp or tree nuts did not differ between northern and central/southern Italy.
  
  
  CONCLUSIONS
  LTP is the most important allergen causing food-induced anaphylaxis in Italy, peach being the most frequently offending food. Peanut-induced anaphylaxis seems very uncommon. Geographic and environmental differences both between Italy and other countries and within Italy seem to play a relevant role in the pattern of sensitization to foods.
authors.affiliation: Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy. r.asero@libero.it
authors.forename: R
authors.initials: R
authors.lastname: Asero
authors.forename: L
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authors.lastname: Antonicelli
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authors.lastname: Arena
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authors.lastname: Bommarito
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authors.lastname: Caruso
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authors.lastname: Colombo
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authors.lastname: Crivellaro
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authors.lastname: De Carli
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authors.lastname: Della Torre
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authors.lastname: Della Torre
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authors.lastname: Heffler
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authors.lastname: Lodi Rizzini
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authors.initials: R
authors.lastname: Longo
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authors.lastname: Manzotti
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authors.lastname: Marcotulli
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authors.lastname: Melchiorre
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authors.lastname: Minale
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authors.lastname: Morandi
authors.forename: B
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authors.lastname: Moreni
authors.forename: A
authors.initials: A
authors.lastname: Moschella
authors.forename: F
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authors.lastname: Murzilli
authors.forename: F
authors.initials: F
authors.lastname: Nebiolo
authors.forename: M
authors.initials: M
authors.lastname: Poppa
authors.forename: S
authors.initials: S
authors.lastname: Randazzo
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authors.lastname: Rossi
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authors.initials: GE
authors.lastname: Senna
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000485:Allergens / Q000276:immunology*; D000707:Anaphylaxis / Q000276:immunology*; D000818:Animals; D002352:Carrier Proteins / Q000276:immunology*; D002648:Child; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D007558:Italy; D008297:Male; D008875:Middle Aged; D009754:Nuts / Q000009:adverse effects*; D017747:Seafood / Q000009:adverse effects*; D014675:Vegetables / Q000009:adverse effects
chemical_list: D000485:Allergens; D002352:Carrier Proteins; C030363:lipid transfer protein