Evaluation of early laryngeal reaction at oral food challenge

BACKGROUND: Open oral food challenge (OFC) is a commonly used diagnostic method for food allergy; however, the occurrence of uncertain reactions leads to inconclusive results. OBJECTIVE: We aimed to determine the associations between mild laryngeal symptoms and positive results in open OFCs. METHODS...

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Autores principales: Nakamura, Toshinori, Okada, Yuki, Maeda, Mayu, Kamiya, Taro, Imai, Takanori
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509976/
https://www.ncbi.nlm.nih.gov/pubmed/37780585
http://dx.doi.org/10.1016/j.jacig.2022.02.002
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author Nakamura, Toshinori
Okada, Yuki
Maeda, Mayu
Kamiya, Taro
Imai, Takanori
author_facet Nakamura, Toshinori
Okada, Yuki
Maeda, Mayu
Kamiya, Taro
Imai, Takanori
author_sort Nakamura, Toshinori
collection PubMed
description BACKGROUND: Open oral food challenge (OFC) is a commonly used diagnostic method for food allergy; however, the occurrence of uncertain reactions leads to inconclusive results. OBJECTIVE: We aimed to determine the associations between mild laryngeal symptoms and positive results in open OFCs. METHODS: We retrospectively investigated medical records of high-risk children (aged 3-15 years) who had undergone open OFC for a low dose of peanuts, hen’s egg, cow’s milk, or wheat. The OFC result, severity of allergic reactions, and administered treatments during OFCs were compared between the subjects with and without laryngeal symptoms. The risks of a positive OFC result were assessed by using logistic univariate and multivariate analyses, with age, sex, and serum levels of total and food-specific IgE as covariates. RESULTS: Among the 198 patients who underwent OFC, 25 had mild laryngeal symptoms: 8 (32%), 7 (22%), 0 (0%), and 10 (40%) in the OFC trials with hen’s egg, cow’s milk, wheat, and peanuts, respectively. In the peanut OFCs, univariate analyses revealed a 5-fold higher risk of a positive result (odds ratio = 5.0 [95% CI = 1.1-22.8]) in the symptomatic subjects than in the asymptomatic subjects. However, on multivariate analyses, none of the associations between the symptoms and a positive result were significant in any of the OFCs. The occurrence of anaphylaxis and adrenalin injections did not differ significantly between the symptomatic and asymptomatic subjects. CONCLUSIONS: Laryngeal symptoms should be considered a warning sign for a positive OFC result in peanut OFCs, although not critical enough to stop the challenge.
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spelling pubmed-105099762023-09-29 Evaluation of early laryngeal reaction at oral food challenge Nakamura, Toshinori Okada, Yuki Maeda, Mayu Kamiya, Taro Imai, Takanori J Allergy Clin Immunol Glob Brief Report BACKGROUND: Open oral food challenge (OFC) is a commonly used diagnostic method for food allergy; however, the occurrence of uncertain reactions leads to inconclusive results. OBJECTIVE: We aimed to determine the associations between mild laryngeal symptoms and positive results in open OFCs. METHODS: We retrospectively investigated medical records of high-risk children (aged 3-15 years) who had undergone open OFC for a low dose of peanuts, hen’s egg, cow’s milk, or wheat. The OFC result, severity of allergic reactions, and administered treatments during OFCs were compared between the subjects with and without laryngeal symptoms. The risks of a positive OFC result were assessed by using logistic univariate and multivariate analyses, with age, sex, and serum levels of total and food-specific IgE as covariates. RESULTS: Among the 198 patients who underwent OFC, 25 had mild laryngeal symptoms: 8 (32%), 7 (22%), 0 (0%), and 10 (40%) in the OFC trials with hen’s egg, cow’s milk, wheat, and peanuts, respectively. In the peanut OFCs, univariate analyses revealed a 5-fold higher risk of a positive result (odds ratio = 5.0 [95% CI = 1.1-22.8]) in the symptomatic subjects than in the asymptomatic subjects. However, on multivariate analyses, none of the associations between the symptoms and a positive result were significant in any of the OFCs. The occurrence of anaphylaxis and adrenalin injections did not differ significantly between the symptomatic and asymptomatic subjects. CONCLUSIONS: Laryngeal symptoms should be considered a warning sign for a positive OFC result in peanut OFCs, although not critical enough to stop the challenge. Elsevier 2022-03-09 /pmc/articles/PMC10509976/ /pubmed/37780585 http://dx.doi.org/10.1016/j.jacig.2022.02.002 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Brief Report
Nakamura, Toshinori
Okada, Yuki
Maeda, Mayu
Kamiya, Taro
Imai, Takanori
Evaluation of early laryngeal reaction at oral food challenge
title Evaluation of early laryngeal reaction at oral food challenge
title_full Evaluation of early laryngeal reaction at oral food challenge
title_fullStr Evaluation of early laryngeal reaction at oral food challenge
title_full_unstemmed Evaluation of early laryngeal reaction at oral food challenge
title_short Evaluation of early laryngeal reaction at oral food challenge
title_sort evaluation of early laryngeal reaction at oral food challenge
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509976/
https://www.ncbi.nlm.nih.gov/pubmed/37780585
http://dx.doi.org/10.1016/j.jacig.2022.02.002
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