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. 2019 Sep;11(5):723-735.
doi: 10.4168/aair.2019.11.5.723.

Clinical Features and Culprit Food Allergens of Korean Adult Food Allergy Patients: A Cross-Sectional Single-Institute Study

Sang Chul Lee  1   2   3 , Sung Ryeol Kim  1   2 , Kyung Hee Park  1   2 , Jae Hyun Lee  1   2 , Jung Won Park  1   4
Affiliations

Clinical Features and Culprit Food Allergens of Korean Adult Food Allergy Patients: A Cross-Sectional Single-Institute Study

Sang Chul Lee et al. Allergy Asthma Immunol Res. 2019 Sep.

Abstract

Purpose: To investigate the causative allergens and clinical characteristics of Korean adult patients with food allergy (FA).

Methods: This retrospective, cross-sectional single-institutional study enrolled Korean adult patients (n = 812) suspected of having FA. For diagnosis, causality assessment history taking, ImmunoCAP specific immunoglobulin E measurement and/or skin prick test were performed.

Results: Among 812 patients, 415 were diagnosed as having FA. The most common causative allergen was fruit, with a diagnosis of pollen food allergy syndrome (PFAS: 155, 37.3%), followed by crustaceans (111, 26.7%), wheat (63, 15.1%), fruits in patients without PFAS(43, 10.3%), buckwheat (31, 7.4%), peanut (31, 7.4%), walnut (25, 6.0%), red meat due to reaction to galactose-α-1,3-galactose (α-Gal) (8, 1.9%), and silkworm pupa (13, 3.1%). Allergy to egg, milk, fish, or shellfish was rare in Korean adults. One-third of patients with FA exhibited multiple FAs (238/415, 57.3%); the average number of causative allergens was 2.39. About 129 patients (31.0%) were diagnosed as having anaphylaxis; in these patients, wheat was the most frequent causative food. Twenty patients were further diagnosed with food-dependent exercise-induced anaphylaxis (FDEIA); all were due to wheat. In particular, crustaceans, wheat, PFAS, buckwheat, and red meat (α-Gal) were also frequent causes of anaphylaxis.

Conclusions: Wheat, fruits with or without PFAS, and crustaceans are important and frequent causative allergens in Korean adult FA; these allergens differ from those found in childhood FA. It is notable that non-classic allergies, such as PFAS, FDEIA, and α-Gal allergy, are the important causes of anaphylaxis in Korean adult FA.

Keywords: Adults; Korea; anaphylaxis; food allergen; food allergy.

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Conflict of interest statement

All authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Proportion of food allergy subtypes and symptom manifestations: (A) food allergy subtypes, (B) symptom manifestations, and (C) symptom onset.
α-Gal, galactose-α-1,3-galactose; FDEIA, food dependent exercise induced anaphylaxis; PFAS, pollen food allergy syndrome.
Fig. 2
Fig. 2. Frequency of food allergens categorized by derivation: (A) grains and legumes, (B) nuts and seeds, (C) other vegetables, (D) fruits, (E) seafood, (F) meat, and (G) other.
Fig. 3
Fig. 3. Proportion of anaphylaxis among food allergy patients.
α-Gal, galactose-α-1,3-galactose. *P value <0.05.
See this image and copyright information in PMC

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