Prevalence and Characteristics of Accidental Ingestions Among Pediatric Food Allergy Patients

Cynhia Hsu, Shweta Hosakoppal, Meagan Yong, Ruchi Gupta, Melanie Makhija, Anne Marie Singh*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Despite a known diagnosis of food allergy, accidental ingestions continue to occur. Objective: To characterize accidental ingestions, including prevalence, risk factors, food allergen triggers, and severity of reactions. Methods: A prospective monthly survey developed by the Food Allergy Consortium at Northwestern University was administered to parents of food-allergic children between April 2015 and April 2017. The monthly survey included questions on any allergic reactions experienced in the previous month. In addition, chart reviews of 100 pediatric participants from Lurie Children's Hospital of Chicago allergy clinics (typical clinical encounters) were compared with the prospective survey results. Results: A total of 196 survey participants and 100 retrospective review subjects were analyzed—31.1% of participants from the surveyed cohort and 19.0% of participants from the retrospective review reported at least 1 accidental ingestion over 1 year. The rate of accidental ingestions reported in the prospective survey was high: 10% to 25% of participants each month reported an accidental ingestion, and multiple ingestions were common. Common triggers were milk, wheat, and tree nuts. In the retrospective cohort, the highest rate of accidental ingestion (25.0%) occurred for milk, followed by sesame (20.0%) and egg (18.8%). Rates of anaphylaxis after exposure were high in both the prospective and retrospective cohorts (33.1% and 16.7%, respectively). Conclusions: Accidental ingestion rates were high among food-allergic patients. Multiple exposures, especially to milk, were common. Incidence of anaphylaxis was also high, suggesting that ongoing patient education on allergen avoidance and accidental exposure is imperative.

Original languageEnglish (US)
Pages (from-to)3089-3095.e2
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume12
Issue number11
DOIs
StatePublished - Nov 2024

Funding

This study was supported by grants from the National Institute of Allergy and Infectious Diseases (grant no. K23 AI100995-03 ), the National Institutes of Health (grant no. XXXXXX to A.M.S.), and Northwestern University (grant no. XXXXXX to A.M.S.). An anonymous grant was made to Northwestern Feinberg School of Medicine . The University of Wisconsin\u2014Madison also received a grant from ________ (grant no. XXXXXX). This study was supported by grants from the National Institute of Allergy and Infectious Diseases (grant no. K23 AI100995-03), the National Institutes of Health (grant no. UG3 OD035509 to A.M.S.), and Northwestern Feinberg School of Medicine (A.M.S., an anonymous grant was made to Northwestern Feinberg School of Medicine. The University of Wisconsin School of Medicine and Public Health also supported this work.Conflicts of interest: M. Makhija reports research support from Aimmune Therapeutics, Regeneron Pharmaceuticals, and DBV Technologies. The rest of the authors declare that they have no relevant conflicts of interest.

Keywords

  • Accidental ingestions
  • Anaphylaxis
  • Food allergy
  • Milk allergy

ASJC Scopus subject areas

  • Immunology and Allergy

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