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

Yonsei Medical Journal 2019년 60권 10호 p.960 ~ 968
 ( Kim Min-Ji ) - Hallym University College of Medicine Hallym University Dongtan Sacred Heart Hospital Department of Pediatrics

안영민 ( Ahn Young-Min ) - Eulji University Eulji Hospital Department of Pediatrics
 ( Yoo Young ) - Korea University College of Medicine Korea University Anam Hospital Department of Pediatrics
 ( Kim Dong-Kyu ) - Hallym University College of Medicine Hallym University Chuncheon Sacred Heart Hospital Department of Otorhinolaryngology-Head and Neck Surgery
 ( Yang Hyeon-Jong ) - Soonchunhyang University College of Medicine Soonchunhyang University Seoul Hospital Department of Pediatrics
 ( Park Hae-Sim ) - Ajou University School of Medicine Department of Allergy and Clinical Immunology
 ( Lee Hyun-Jong ) - Sleep and Cosmetic Center Lee & Hong ENT
 ( Kim Mi-Ae ) - CHA University CHA Bundang Medical Center Department of Pulmonology, Allergy and Critical Care Medicine
 ( Jeong Yi-Yeong ) - Gyeongsang National University School of Medicine Department of Internal Medicine
김봉성 ( Kim Bong-Seong ) - University of Ulsan College of Medicine Gangneung Asan Hospital Department of Pediatrics
배우용 ( Bae Woo-Yong ) - Dong-A University College of Medicine Department of Otorhinolaryngology-Head and Neck Surgery
 ( Jang An-Soo ) - Soonchunhyang University Bucheon Hospital Department of Internal Medicine
 ( Park Yang ) - Wonkwang University College of Medicine Wonkwang University Sanbon Hospital Department of Pediatrics
 ( Koh Young-Il ) - Chonnam National University Medical School Chonnam National University Hospital Department of Internal Medicine
이재천 ( Lee Jae-Chun ) - Jeju National University School of Medicine Department of Internal Medicine
 ( Lim Dae-Hyun ) - Inha University School of Medicine Inha University Hospital Department of Pediatrics
김정희 ( Kim Jeong-Hee ) - Inha University School of Medicine Inha University Hospital Department of Pediatrics
 ( Lee Sang-Min ) - Gachon University College of Medicine Gil Medical Center Department of Internal Medicine
 ( Kim Yong-Min ) - Chungnam National University School of Medicine Department of Otorhinolaryngology-Head and Neck Surgery
 ( Jun Young-Joon ) - Soonchunhyang University College of Medicine Soonchunhyang University Gumi Hospital Department of Otorhinolaryngology-Head and Neck Surgery
김효열 ( Kim Hyo-Yeol ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Otorhinolaryngology-Head and Neck Surgery
 ( Kim Yun-Sun ) - Soonchunhyang University Seoul Hospital SCH Biomedical Informatics Research Unit
 ( Choi Jeong-Hee ) - Hallym University College of Medicine Hallym University Dongtan Sacred Heart Hospital Department of Pulmonology and Allergy

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.

키워드

Pollen-food allergy syndrome; pollen; food allergy; anaphylaxis
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