Clinical Manifestations and Risk Factors of Anaphylaxis in Pollen-Food Allergy Syndrome

Work Group for Rhinitis, the Korean Academy of Asthma, Allergy and Clinical Immunology

Research output: Contribution to journalArticle

Abstract

PURPOSE: Many studies have reported that pollen-food allergy syndrome (PFAS) can cause anaphylaxis. No comprehensive investigations into anaphylaxis in PFAS have been conducted, however. In this study, we investigated the clinical manifestations and risk factors for anaphylaxis in PFAS in Korean patients with pollinosis. MATERIALS AND METHODS: Data were obtained from a nationwide cross-sectional study that previously reported on PFAS in Korean patients with pollinosis. Data from 273 patients with PFAS were collected, including demographics, list of culprit fruits and vegetables, and clinical manifestations of food allergy. We analyzed 27 anaphylaxis patients and compared them with patients with PFAS with oropharyngeal symptoms only (n=130). RESULTS: The most common cause of anaphylaxis in PFAS was peanut (33.3%), apple (22.2%), walnut (22.2%), pine nut (18.5%), peach (14.8%), and ginseng (14.8%). Anaphylaxis was significantly associated with the strength of sensitization to alder, hazel, willow, poplar, timothy, and ragweed (p<0.05, respectively). Multivariable analysis revealed that the presence of atopic dermatitis [odds ratio (OR), 3.58; 95% confidence interval (CI), 1.25-10.23; p=0.017]; sensitization to hazel (OR, 5.27; 95% CI, 1.79-15.53; p=0.003), timothy (OR, 11.8; 95% CI, 2.70-51.64; p=0.001), or ragweed (OR, 3.18; 95% CI, 1.03-9.87; p=0.045); and the number of culprit foods (OR, 1.25; 95% CI, 1.15-1.37; p<0.001) were related to the development of anaphylaxis in PFAS. CONCLUSION: The most common culprit foods causing anaphylaxis in PFAS were peanut and apple. The presence of atopic dermatitis; sensitization to hazel, timothy, or ragweed; and a greater number of culprit foods were risk factors for anaphylaxis in PFAS.

Original languageEnglish
Pages (from-to)960-968
Number of pages9
JournalYonsei medical journal
Volume60
Issue number10
DOIs
Publication statusPublished - 2019 Oct 1

Fingerprint

Seasonal Allergic Rhinitis
Food Hypersensitivity
Anaphylaxis
Ambrosia
Odds Ratio
Confidence Intervals
Malus
Atopic Dermatitis
Food
Alnus
Salix
Juglans
Panax
Nuts
Vegetables
Fruit
Cross-Sectional Studies
Demography

Keywords

  • anaphylaxis
  • food allergy
  • pollen
  • Pollen-food allergy syndrome

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Work Group for Rhinitis, the Korean Academy of Asthma, Allergy and Clinical Immunology (2019). Clinical Manifestations and Risk Factors of Anaphylaxis in Pollen-Food Allergy Syndrome. Yonsei medical journal, 60(10), 960-968. https://doi.org/10.3349/ymj.2019.60.10.960

Clinical Manifestations and Risk Factors of Anaphylaxis in Pollen-Food Allergy Syndrome. / Work Group for Rhinitis, the Korean Academy of Asthma, Allergy and Clinical Immunology.

In: Yonsei medical journal, Vol. 60, No. 10, 01.10.2019, p. 960-968.

Research output: Contribution to journalArticle

Work Group for Rhinitis, the Korean Academy of Asthma, Allergy and Clinical Immunology 2019, 'Clinical Manifestations and Risk Factors of Anaphylaxis in Pollen-Food Allergy Syndrome', Yonsei medical journal, vol. 60, no. 10, pp. 960-968. https://doi.org/10.3349/ymj.2019.60.10.960
Work Group for Rhinitis, the Korean Academy of Asthma, Allergy and Clinical Immunology. Clinical Manifestations and Risk Factors of Anaphylaxis in Pollen-Food Allergy Syndrome. Yonsei medical journal. 2019 Oct 1;60(10):960-968. https://doi.org/10.3349/ymj.2019.60.10.960
Work Group for Rhinitis, the Korean Academy of Asthma, Allergy and Clinical Immunology. / Clinical Manifestations and Risk Factors of Anaphylaxis in Pollen-Food Allergy Syndrome. In: Yonsei medical journal. 2019 ; Vol. 60, No. 10. pp. 960-968.
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abstract = "PURPOSE: Many studies have reported that pollen-food allergy syndrome (PFAS) can cause anaphylaxis. No comprehensive investigations into anaphylaxis in PFAS have been conducted, however. In this study, we investigated the clinical manifestations and risk factors for anaphylaxis in PFAS in Korean patients with pollinosis. MATERIALS AND METHODS: Data were obtained from a nationwide cross-sectional study that previously reported on PFAS in Korean patients with pollinosis. Data from 273 patients with PFAS were collected, including demographics, list of culprit fruits and vegetables, and clinical manifestations of food allergy. We analyzed 27 anaphylaxis patients and compared them with patients with PFAS with oropharyngeal symptoms only (n=130). RESULTS: The most common cause of anaphylaxis in PFAS was peanut (33.3{\%}), apple (22.2{\%}), walnut (22.2{\%}), pine nut (18.5{\%}), peach (14.8{\%}), and ginseng (14.8{\%}). Anaphylaxis was significantly associated with the strength of sensitization to alder, hazel, willow, poplar, timothy, and ragweed (p<0.05, respectively). Multivariable analysis revealed that the presence of atopic dermatitis [odds ratio (OR), 3.58; 95{\%} confidence interval (CI), 1.25-10.23; p=0.017]; sensitization to hazel (OR, 5.27; 95{\%} CI, 1.79-15.53; p=0.003), timothy (OR, 11.8; 95{\%} CI, 2.70-51.64; p=0.001), or ragweed (OR, 3.18; 95{\%} CI, 1.03-9.87; p=0.045); and the number of culprit foods (OR, 1.25; 95{\%} CI, 1.15-1.37; p<0.001) were related to the development of anaphylaxis in PFAS. CONCLUSION: The most common culprit foods causing anaphylaxis in PFAS were peanut and apple. The presence of atopic dermatitis; sensitization to hazel, timothy, or ragweed; and a greater number of culprit foods were risk factors for anaphylaxis in PFAS.",
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AU - Work Group for Rhinitis, the Korean Academy of Asthma, Allergy and Clinical Immunology

AU - Kim, Minji

AU - Ahn, Youngmin

AU - Yoo, Young

AU - Kim, Dong Kyu

AU - Yang, Hyeon Jong

AU - Park, Hae Sim

AU - Lee, Hyun Jong

AU - Kim, Mi Ae

AU - Jeong, Yi Yeong

AU - Kim, Bong Seong

AU - Bae, Woo Yong

AU - Jang, An Soo

AU - Park, Yang

AU - Koh, Young Il

AU - Lee, Jaechun

AU - Lim, Dae Hyun

AU - Kim, Jeong Hee

AU - Lee, Sang Min

AU - Kim, Yong Min

AU - Jun, Young Joon

AU - Kim, Hyo Yeol

AU - Kim, Yunsun

AU - Choi, Jeong Hee

PY - 2019/10/1

Y1 - 2019/10/1

N2 - PURPOSE: Many studies have reported that pollen-food allergy syndrome (PFAS) can cause anaphylaxis. No comprehensive investigations into anaphylaxis in PFAS have been conducted, however. In this study, we investigated the clinical manifestations and risk factors for anaphylaxis in PFAS in Korean patients with pollinosis. MATERIALS AND METHODS: Data were obtained from a nationwide cross-sectional study that previously reported on PFAS in Korean patients with pollinosis. Data from 273 patients with PFAS were collected, including demographics, list of culprit fruits and vegetables, and clinical manifestations of food allergy. We analyzed 27 anaphylaxis patients and compared them with patients with PFAS with oropharyngeal symptoms only (n=130). RESULTS: The most common cause of anaphylaxis in PFAS was peanut (33.3%), apple (22.2%), walnut (22.2%), pine nut (18.5%), peach (14.8%), and ginseng (14.8%). Anaphylaxis was significantly associated with the strength of sensitization to alder, hazel, willow, poplar, timothy, and ragweed (p<0.05, respectively). Multivariable analysis revealed that the presence of atopic dermatitis [odds ratio (OR), 3.58; 95% confidence interval (CI), 1.25-10.23; p=0.017]; sensitization to hazel (OR, 5.27; 95% CI, 1.79-15.53; p=0.003), timothy (OR, 11.8; 95% CI, 2.70-51.64; p=0.001), or ragweed (OR, 3.18; 95% CI, 1.03-9.87; p=0.045); and the number of culprit foods (OR, 1.25; 95% CI, 1.15-1.37; p<0.001) were related to the development of anaphylaxis in PFAS. CONCLUSION: The most common culprit foods causing anaphylaxis in PFAS were peanut and apple. The presence of atopic dermatitis; sensitization to hazel, timothy, or ragweed; and a greater number of culprit foods were risk factors for anaphylaxis in PFAS.

AB - PURPOSE: Many studies have reported that pollen-food allergy syndrome (PFAS) can cause anaphylaxis. No comprehensive investigations into anaphylaxis in PFAS have been conducted, however. In this study, we investigated the clinical manifestations and risk factors for anaphylaxis in PFAS in Korean patients with pollinosis. MATERIALS AND METHODS: Data were obtained from a nationwide cross-sectional study that previously reported on PFAS in Korean patients with pollinosis. Data from 273 patients with PFAS were collected, including demographics, list of culprit fruits and vegetables, and clinical manifestations of food allergy. We analyzed 27 anaphylaxis patients and compared them with patients with PFAS with oropharyngeal symptoms only (n=130). RESULTS: The most common cause of anaphylaxis in PFAS was peanut (33.3%), apple (22.2%), walnut (22.2%), pine nut (18.5%), peach (14.8%), and ginseng (14.8%). Anaphylaxis was significantly associated with the strength of sensitization to alder, hazel, willow, poplar, timothy, and ragweed (p<0.05, respectively). Multivariable analysis revealed that the presence of atopic dermatitis [odds ratio (OR), 3.58; 95% confidence interval (CI), 1.25-10.23; p=0.017]; sensitization to hazel (OR, 5.27; 95% CI, 1.79-15.53; p=0.003), timothy (OR, 11.8; 95% CI, 2.70-51.64; p=0.001), or ragweed (OR, 3.18; 95% CI, 1.03-9.87; p=0.045); and the number of culprit foods (OR, 1.25; 95% CI, 1.15-1.37; p<0.001) were related to the development of anaphylaxis in PFAS. CONCLUSION: The most common culprit foods causing anaphylaxis in PFAS were peanut and apple. The presence of atopic dermatitis; sensitization to hazel, timothy, or ragweed; and a greater number of culprit foods were risk factors for anaphylaxis in PFAS.

KW - anaphylaxis

KW - food allergy

KW - pollen

KW - Pollen-food allergy syndrome

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