Alergia alimentar IgE mediada em uma coorte prospectiva no primeiro ano de vida

Abstract

ABSTRACT Background Food allergy is defined as an adverse immune response that occurs after contact with or ingestion of a specific food. Since the clinical history can be confusing, diagnosis is challenging and may result in an overestimation of incidence, as already documented in other countries. A careful diagnosis of food allergies reflects significantly lower numbers than current estimates. Objective To establish the incidence of food allergies in the first year of life in children born in the city of Uberlândia/MG. Methods Between the years 2019 and 2022, the following steps were conducted based on the follow-up of newborns from two maternity hospitals in Uberlândia, located in the central region of Brazil: (1) an interview at the maternity ward; (2) a follow-up telephone interview after 12 months; (3) an online consultation for the investigation of suspected food allergy; and (4) the clinical evaluation and performance of allergic tests and oral food challenges for diagnostic confirmation. Results Out of the 3373 recruited newborns at the maternity ward, 2099 participated in the telephone interview after 12 months, and 144 with suspected food allergies underwent diagnostic confirmation. Seventeen skin prick tests and thirteen oral food challenges were performed on sixteen infants for eleven different foods. Only five participants confirmed food allergies to eggs (4), cow's milk (1), and peanuts (1). The incidence of IgE-mediated food allergies in the first year of life was 0.23%, while the incidence per food was 0.19% for eggs and 0.05% for both milk and peanuts. Conclusion The study demonstrates a reduced incidence of food allergy compared to previous studies and emphasizes the importance of confirming the diagnosis through oral food challenges. This practice reduces the number of unnecessary food exclusions, improving the quality of life for patients and their families, preventing potential growth and developmental impairments in infants, and reducing public spending on the treatment of food allergies. Keywords: infants; food allergy; oral food challenge.