429 Natural History of Food Allergy in Childhood -3 Years' Follow up of Pediatric Food Allergy Patients

BACKGROUND: Food allergy (FA) is prevalent among children however natural history of FA is not fully clarified. METHODS: We sought to investigate the natural course of childhood FA. To follow up the transition of same patients, we collected clinical records of patients with 3 years’ interval from 2008 to 2010. Four hundred ninety-one patients (male 321 and female 170) were recruited to this study. RESULTS: The onset of FA was at the age of 5 months ± 1 year 3 month (mean ± SD). The clinical type at the onset was with infantile atopic eczema (84.1%), and followed by immediate reactions without eczema (14.9%). The initial diagnosis age was 10 months ± 1 year 4 months, and the first visit to our department was 1 year 11 month ± 2 years 5 months. Current age of the patients was 7 years 5 months ± 2 years 11 months, and 444 patients (90.4%) had experienced immediate reactions. The number of eliminated foods decreased from 2.4 ± 1.5 items/patient (n = 1191) to 1.9 ± 1.6 items/patient (n = 926) in 3 years. The ratio of stopping elimination of major allergens was 35.9% (121/337 patients) for hen's egg, 25.6% (52/203 patients) for cow's milk and 47.8% (44/92 patients) for wheat. Fourteen patients (2.9%) had developed new food allergies, and 2 of them had experienced anaphylaxis by tree nuts. Newly diagnosed allergens were only 0.1 ± 0.3 items/patient (n = 32), and nuts (n = 6) and peanut (n = 5) were the most frequent. Seventy-nine patients (16.1%) had developed complete remission of FA in 3 years, and 21.5% of them (17 patients) had never developed immediate reactions. CONCLUSIONS: Most of pediatric FA started during infancy with atopic eczema, and developing tolerance is expected with aging. In some patients, persistent FA is troublesome for school age children.