October 18, 2016
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Self-reports of allergy unreliable in parents of children with food allergies

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Few parents of children with food allergies who self-report a current food allergy were actually found to have sensitivity to the reported allergen, according to study results published in the Annals of Allergy, Asthma and Immunology.

“Parents of kids with food allergies had a higher rate of positive blood and skin tests to foods than the general population,” Melanie M. Makhija, MD, MSc, an allergist at the Ann and Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, said in a press release. “But of 2,477 parents, only 28% of those who self-reported a food allergy actually tested positive. This tells us that either people haven’t been tested and are assuming an allergy from a previous reaction to a food, or they haven’t been tested properly and may not truly have an allergy. Allergy testing, including blood and skin prick testing, are not always reliable; there are a lot of false positives.”

To determine the association between self-reports of allergy with specific immunoglobulin measurements and to investigate the patterns of allergen sensitization in adults, Makhija and colleagues enrolled 1,252 mothers and 1,225 fathers of children with food allergies from community and clinic settings in Chicago during a 3-year period. Families had to have one child with a food allergy to be included in the study. Parents responded to a questionnaire prior to blood tests for nine food allergens and skin prick tests for nine food allergens and five perennial environmental allergens.

On the questionnaire, 13.7% of parents reported a current food allergy, including shellfish (3.6%), milk (2.1%), peanut (2.1%), tree nuts (2.1%), fish (1.4%) egg (1.1%), soy (1%), wheat (0.9%) and sesame (0.3%). Among those reporting a current food allergy, only 28.4% of had sensitization to the allergen for which the reported disease. Parents who self-reported food allergies were significantly more susceptible to asthma and environmental allergies compared with parents who did not self-report food allergy (P < .01). In addition, parents who reported asthma and environmental allergies had increased sensitization to any food or environmental allergen (P < .01).

In logistic regression analysis, predictors of self-reported food allergy among fathers were self-reported asthma, environmental allergy and eczema. Positive associations in mothers with self-reported food allergy existed between environmental allergies and having more than one child with food allergic disease.

“Our study suggests that using parental report of food allergy as a risk factor is unreliable,” the researchers wrote. “Other known risk factors, such as infant eczema, may be better for predicting the risk of future food allergy in a child. More epidemiologic studies of food allergy in the adult population that include proper testing and food challenge outcomes are needed to better understand sensitization and heritability.” – by Kate Sherrer

Disclosure: Makhija reports no relevant financial disclosures. Please see the full study for a list of all other authors’ financial disclosures.