Food allergy related to specific primary immunodeficiency diseases
While food allergy and atopic dermatitis in patients with primary immunodeficiency diseases was less prevalent than in the general population, food allergy was more commonly related to specific primary immunodeficiency diseases, according to recent study results.
Researchers conducted a query of 2,923 patients with primary immunodeficiency diseases (PIDDs) registered in the US Immunodeficiency Network (USIDNET). Responses to “allergic reactions to food” and “atopic dermatitis (AD)/eczema” were cross-referenced to diagnoses.
There were 2,263 responders to questions regarding food allergy reactions and AD/eczema, with 14 diagnoses associated with food allergy (FA), AD or both. FA and AD prevalence in patients with PIDDs was lower than observed in the general population (1.8% vs. 2.5% and 6% vs. 10.7%, respectively).
“FA was more commonly reported in patients with specific PIDDs when compared with what would be expected in the general population,” the researchers wrote. PIDDs included CD40 ligand deficiency (7.7%), primary hypogammaglobulinemia (7.1%), and hyper-IgE syndrome (HIES; 6.3%). While there were very few patients in the registry, those with combined immunodeficiency (CID; 33.3%) and selective IgA deficiency (25%) showed increased prevalence. Anaphylaxis (20%) was the most commonly reported reaction, along with angioedema, asthma, brochospasm, dermatitis, and urticaria.
AD was most likely to be reported by patients with nuclear factor kB (62.5%), followed by Wiskott-Aldrich syndrome (41.5%), CID (33.3%), selective IgM deficiency (33.3%) and HIES (25%). Common variable immunodeficiency, CID and HIES were PIDDs associated with FA and AD.
“The number of patients with FA, AD or both registered in the USIDNET … was small and this might underrepresent PIDDs associated with atopy,” the researchers wrote.
“Manifestation of atopy, such as FA and AD, occurring early in life might be a presenting feature before diagnosis of a PIDD and, if associated with recurrent infections, should warrant clinicians to pursue an immunologic evaluation,” the researchers concluded.
Disclosure: See the study for a full list of relevant financial disclosures.