B. Pereira

Prevalence and cumulative incidence of food hypersensitivity in the first 3 years of life

Background:  Prevalence and incidence of food hypersensitivity (FHS) and its trends in early childhood are unclear.

Time trends in the prevalence of peanut allergy: three cohorts of children from the same geographical location in the UK

Background:  This article investigated the prevalence of peanut allergy in three cohorts of children born in the same geographical location, Isle of Wight, UK and seeks to determine whether the prevalence of peanut allergy has changed between 1994 and 2004.

Prevalence of sensitization reported and objectively assessed food hypersensitivity amongst six‐year‐old children: A population‐based study

There is a paucity of information on food hypersensitivity (FHS) in young children and there are even fewer population‐based studies in this area. The aim of the study was to determine the prevalence of parentally reported FHS, and objectively diagnosed FHS amongst six‐year‐old children and to establish the rates of sensitization to key allergens. This population‐based cohort study recruited 798 6‐year‐olds resident on the Isle of Wight (UK). Sensitization rates, reported rates of FHS and objectively assessed FHS was established using food challenges. A total of 94 (11.8%) 6 yr olds reported a problem with a food or food ingredient. The rate of sensitization to the pre‐defined panel of food allergens was 25/700 (3.6%). Based on open food challenge and/or suggestive history and skin tests, the prevalence of FHS was 2.5% (95% CI 1.5–3.8). Based on double‐blind challenges, a clinical diagnosis or suggestive history and positive skin tests, the prevalence was 1.6% (95% CI 0.9–2.7). The rates of perception of FHS are higher than the prevalence of sensitization to main food allergens and the prevalence of FHS based on food challenges. Milk, peanut and wheat were the key food allergens amongst those with positive challenges.

Factors associated with maternal dietary intake, feeding and weaning practices, and the development of food hypersensitivity in the infant

Maternal diet during pregnancy and breastfeeding, as well as infant feeding and weaning practices, may play a role in the development of sensitization to food and food hypersensitivity (FHS) and need further investigation. Pregnant women were recruited at 12 wk pregnancy. Information regarding family history of allergy was obtained by means of a questionnaire. A food frequency questionnaire was completed at 36 wk gestation. Information regarding feeding practices and reported symptoms of atopy was obtained during the infants’ first 3 yr of life. Children were also skin‐prick tested at 1, 2 and 3 yr to a pre‐defined panel of food allergens. Food challenges were conducted where possible. Maternal dietary intake during pregnancy, and breast‐feeding duration did not influence the development of sensitization to food allergens or FHS, but weaning age (≥16 wk) did for sensitization at 1 yr (p = 0.03), FHS by 1 yr (p = 0.02), sensitization at 3 yr (p = 0.01) and FHS by 3 yr (p = 0.02). In contrast, children who were not exposed to a certain food allergen before the age of 3–6 months were less likely to become sensitized or develop FHS. Women with a family history of allergic disease were more likely to breastfeed exclusively at 3 months (p = 0.008) and avoid peanuts from the infant’s diet at 6 months (p = 0.03). Maternal dietary intake during pregnancy, and breast‐feeding duration did not appear to influence the development of sensitization to food allergens or FHS. Weaning age may affect sensitization to foods and development of FHS. A history of allergic disease has very little impact on maternal dietary, feeding, and weaning practices.

Hepatitis C and urticaria: cause and effect?

Urticaria is a commondisorder that affects as many as 20% of the population at some point during their lifetime. Factors believed to cause or aggravate urticaria include drugs, foods, additives, connective tissue disorders and infections. It is well established that hepatitis B virus causes urticaria (1). Whether hepatitis C infection causes urticaria or not is still debated. There have been conflicting reports both in favour of (2,3) and against (4,5) hepatitis C virus (HCV) causing urticaria. Kanazawa and colleagues (2) reported a positive relationship between hepatitis C and urticaria. Nineteen of 79 patients tested were found to be positive for HCV. Subsequent studies however did not confirm such an association (4,5). We describe here a case of chronic intermittent urticaria caused by HCV. A 49-year-old Caucasian man presented with a typical history of recurrent urticaria of several months duration. There were no clues in the history apart from promiscuity, and all routine screening investigations were negative apart from an approximately three times raised alanine aminotransferase (ALT). In view of a history of multiple sexual partners and raised ALT, hepatitis serology was requested. Hepatitis C antibody was reported to be positive by both enzymelinked immunosorbent assay (ELISA) and microparticle enzyme immune assay. Results of ELISA for hepatitis B were negative.We conclude that HCV infection may have caused urticaria in this patient. There does not appear to be any clearcut evidence to affirm or refute a direct link between chronic urticaria and HCV infection in the literature. We suggest that HCV status should be checked in patients presenting with urticaria in areas with a high prevalence. It may not be cost-effective to perform routine screening forHCVwhere the prevalence of this infection is low, but should be considered where the history or laboratory tests suggest this possibility. Further studies are needed to establish any definite association, possible aetiopathogenic role and the cost implications of screening and therapy of HCV in chronic urticaria.

Original article: Prevalence and cumulative incidence of food hypersensitivity in the first 3 years of life

Background:  Prevalence and incidence of food hypersensitivity (FHS) and its trends in early childhood are unclear.

Original article: Prevalence and cumulative incidence of food hypersensitivity in the first 3 years of life: Prevalence and cumulative incidence of FHS

Background:  Prevalence and incidence of food hypersensitivity (FHS) and its trends in early childhood are unclear.