New Study: Link Between Atopic Eczema & Food Allergies
More Kiwi children will be at risk from developing food allergies unless preventative strategies are put in place immediately says an international expert.
New Zealand has one of the highest rates of food allergies in the world and the number of infants being diagnosed with food allergy and early on-set eczema is on the rise, says visiting Paediatric Gastroenterologist and Allergist Dr Ralf Heine.
Dr Heine, Senior Staff Specialist at the Department of Allergy and Immunology at the Royal Children’s Hospital, University of Melbourne, is in New Zealand to present new research to GPs and paediatricians in a series of seminars throughout the country.
Dr Heine says a recent study shows a large proportion of infants suffering from atopic eczema of moderate severity suffer from allergies to foods, including cow’s milk, egg or peanuts. Many of these infants were sensitized to more than one food item.
Eczema in infancy is closely associated with food allergies, he says. More than 60% of moderate to severe eczema in infants under six months is due to food allergy*. However, food allergies in infants are often not recognized. Dietary treatment has become an integral part of the treatment of eczema in infants, says Dr Heine.
-Ends-
Notes to editors:
*Ref: Hill DJ et al., Clinical and Experimental Allergy 2008; 38: 161-168
: Clin Exp Allergy. 2008 Jan;38(1):161-8. Epub 2007 Nov 19
Confirmation of the association between high levels of immunoglobulin E food sensitization and eczema in infancy: an international study
Hill DJ, Hosking CS, de Benedictis FM, Oranje AP, Diepgen TL, Bauchau V; EPAAC Study Group.
Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia. dave.hill@bigpond.com
BACKGROUND: Studies of Australian infants have reported that more than 80% of those with moderate atopic eczema (AE) have high levels of IgE food sensitization (IgE-FS) that are commonly associated with IgE food allergy. OBJECTIVES: To explore the relationship between high levels of IgE-FS and AE in a large cohort of young children with eczema participating in a multi-centre, international study. METHODS: Two thousand one hundred and eighty-four subjects (mean age 17.6 months, range 11.8-25.4; 1246 males) with active eczema from atopic families from 94 centres in 12 countries were studied. Clinical history, Scoring Atopic Dermatitis index as a measure of eczema severity and CAP-FEIA measurements for total IgE and IgE antibody levels to cow milk, egg and peanut were entered into a database. If CAP-FEIA levels exceeded previously reported age-specific cut-off levels for 95% positive predictive values (PPVs) for food allergy, subjects were defined as having high-risk IgE-FS (HR-IgE-FS). RESULTS: Serum was available from 2048 patients; 55.5% were atopic. The frequency of HR-IgE-FS to milk, egg and/or peanut was the greatest in patients whose eczema developed in the first 3 months of life and the least in those whose eczema developed after 12 months (P<0.0001). In a regression analysis to allow for potential confounding factors, children with HR-IgE-FS had the most severe eczema and the youngest age of onset (P<0.001); 64% of infants with severe eczema of onset-age <3 months had HR-IgE-FS. CONCLUSION: Early-onset severe eczema in infancy was associated with HR-IgE-FS. Clinical implications Food allergies should be routinely assessed in infants with moderate or severe eczema. Capsule summary In eczematous infants, the earlier the age of onset, and the greater the severity of eczema, the greater the frequency of associated high levels of IgE-FS.