Food allergy in the Netherlands: differences in clinical severity, causative foods, sensitization and DBPCFC between community and outpatients

Background: It is unknown whether food allergy (FA) in an unselected population is comparable to those from an outpatient clinic population. Objective: To discover if FA in a random sample from the Dutch community is comparable to that of outpatients. Methods: This study was part of the Europrevall-project. A random sample of 6600 adults received a questionnaire. Those with symptoms to one of 24 defined priority foods were tested for sΙgE. Participants with a positive case history and elevated sIgE were evaluated by double-blind placebo-controlled food challenge (DBPCFC). Outpatients with a suspicion of FA were evaluated by questionnaire, sIgE and DBPCFC. Results: In the community, severe symptoms were reported less often than in outpatients (39.3% vs. 54.3%). Participants in the community were less commonly sensitized to any of the foods. When selecting only those with a probable FA (i.e. symptoms of priority food and elevation of sIgE to the respective food), no major differences were observed with respect to severity, causative foods, sensitization and DBPCFC between the groups. Conclusion: In the Netherlands, there are large differences in self-reported FA between community and outpatients. However, Dutch community and outpatients with a probable FA do not differ with respect to severity, causative foods, sensitization and DBPCFC-outcome

Food allergy in the Netherlands : differences in clinical severity, causative foods, sensitization and DBPCFC between community and outpatients

BACKGROUND: It is unknown whether food allergy (FA) in an unselected population is comparable to those from an outpatient clinic population. OBJECTIVE: To discover if FA in a random sample from the Dutch community is comparable to that of outpatients. METHODS: This study was part of the Europrevall-project. A random sample of 6600 adults received a questionnaire. Those with symptoms to one of 24 defined priority foods were tested for sIgE. Participants with a positive case history and elevated sIgE were evaluated by double-blind placebo-controlled food challenge (DBPCFC). Outpatients with a suspicion of FA were evaluated by questionnaire, sIgE and DBPCFC. RESULTS: In the community, severe symptoms were reported less often than in outpatients (39.3% vs. 54.3%). Participants in the community were less commonly sensitized to any of the foods. When selecting only those with a probable FA (i.e. symptoms of priority food and elevation of sIgE to the respective food), no major differences were observed with respect to severity, causative foods, sensitization and DBPCFC between the groups. CONCLUSION: In the Netherlands, there are large differences in self-reported FA between community and outpatients. However, Dutch community and outpatients with a probable FA do not differ with respect to severity, causative foods, sensitization and DBPCFC-outcome

Food allergy in adults: substantial variation in prevalence and causative foods across Europe

BACKGROUND: The EuroPrevall study showed that prevalence of self-reported food allergy (FA) in adults across Europe ranged from 2-37% for any food and 1-19% for 24 selected foods. OBJECTIVE: To determine prevalence of probable FA (symptoms plus sIgE-sensitisation) and challenge-confirmed FA in European adults, along with symptoms and causative foods. METHODS: In phase I of the EuroPrevall project, a screening questionnaire was sent to a random sample of the general adult population in eight European centres. Phase II consisted of an extensive questionnaire on reactions to 24 pre-selected commonly implicated foods, and measurement of sIgE. Multiple imputation was performed performed to estimate missing symptom and serology information for non-responders. In the final phase, subjects with probable FA were invited for double-blind placebo-controlled food challenge. RESULTS: Prevalence of probable FA in adults in Athens, Reykjavik, Utrecht, Lodz, Madrid and Zurich was respectively 0.3%, 1.4%, 2.1%, 2.8%, 3.3% and 5.6%. Oral allergy symptoms were reported most frequently (81.6%), followed by skin symptoms (38.2%) and rhino-conjunctivitis (29.5%). Hazelnut, peach and apple were the most common causative foods in Lodz, Utrecht and Zurich. Peach was also among the top three causative foods in Athens and Madrid. Shrimp and fish allergies were relatively common in Madrid and Reykjavik. Of the 55 food challenges performed, 72.8% was classified as positive. CONCLUSION: Food allergy shows substantial geographical variation in prevalence and causative foods across Europe. Although probable FA is less common than self-reported FA, prevalence still reaches 6% in parts of Europe