title: Food allergy in the Netherlands: differences in clinical severity, causative foods, sensitization and DBPCFC between community and outpatients.
abstract: BACKGROUND
  It is unknown whether food allergy (FA) in an unselected population is comparable to those from an outpatient clinic population.
  
  
  OBJECTIVE
  To discover if FA in a random sample from the Dutch community is comparable to that of outpatients.
  
  
  METHODS
  This study was part of the Europrevall-project. A random sample of 6600 adults received a questionnaire. Those with symptoms to one of 24 defined priority foods were tested for sIgE. Participants with a positive case history and elevated sIgE were evaluated by double-blind placebo-controlled food challenge (DBPCFC). Outpatients with a suspicion of FA were evaluated by questionnaire, sIgE and DBPCFC.
  
  
  RESULTS
  In the community, severe symptoms were reported less often than in outpatients (39.3% vs. 54.3%). Participants in the community were less commonly sensitized to any of the foods. When selecting only those with a probable FA (i.e. symptoms of priority food and elevation of sIgE to the respective food), no major differences were observed with respect to severity, causative foods, sensitization and DBPCFC between the groups.
  
  
  CONCLUSIONS
  In the Netherlands, there are large differences in self-reported FA between community and outpatients. However, Dutch community and outpatients with a probable FA do not differ with respect to severity, causative foods, sensitization and DBPCFC-outcome.
authors.affiliation: Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Thuy-My
authors.initials: TM
authors.lastname: Le
authors.affiliation: Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands ; Current affiliation: NIZO food research, Ede, The Netherlands.
authors.forename: Els
authors.initials: E
authors.lastname: van Hoffen
authors.affiliation: Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands ; Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK.
authors.forename: Ischa
authors.initials: I
authors.lastname: Kummeling
authors.affiliation: Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK.
authors.forename: James
authors.initials: J
authors.lastname: Potts
authors.affiliation: Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Ballmer-Weber
authors.affiliation: Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Carla Afm
authors.initials: CA
authors.lastname: Bruijnzeel-Koomen
authors.affiliation: Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Ans Fm
authors.initials: AF
authors.lastname: Lebens
authors.affiliation: Thermo Fisher Scientific, Uppsala, Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Lidholm
authors.affiliation: Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Titia M
authors.initials: TM
authors.lastname: Lindner
authors.affiliation: Institute of Food Research, Norwich Research Park, Colney, Norwich, NR4 7UA UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Mackie
authors.affiliation: Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre, Manchester Institute of Biotechnology, The University of Manchester, Manchester, UK.
authors.forename: En Clare
authors.initials: EC
authors.lastname: Mills
authors.affiliation: Department of Experimental Immunology and Department of Otorhinolaryngology, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Ronald
authors.initials: R
authors.lastname: van Ree
authors.affiliation: Division of Allergology, Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Vieths
authors.affiliation: Allergy Department, Hospital Clinico San Carlos, IdISSC, Madrid, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Fernández-Rivas
authors.affiliation: Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Burney
authors.affiliation: Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: André C
authors.initials: AC
authors.lastname: Knulst
keywords: Adults; Community; DBPCFC; Food allergy; sIgE