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

Thuy-My Le; Els van Hoffen; Ischa Kummeling; James Potts; Barbara K Ballmer-Weber; Carla Afm Bruijnzeel-Koomen; Ans Fm Lebens; Jonas Lidholm; Titia M Lindner; Alan Mackie; En Clare Mills; Ronald van Ree; Stefan Vieths; Montserrat Fernández-Rivas; Peter G Burney; André C Knulst

doi:10.1186/s13601-015-0051-1

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

Clin Transl Allergy. 2015 Feb 25:5:8. doi: 10.1186/s13601-015-0051-1. eCollection 2015.

Authors

Thuy-My Le¹, Els van Hoffen², Ischa Kummeling³, James Potts⁴, Barbara K Ballmer-Weber⁵, Carla Afm Bruijnzeel-Koomen¹, Ans Fm Lebens¹, Jonas Lidholm⁶, Titia M Lindner¹, Alan Mackie⁷, En Clare Mills⁸, Ronald van Ree⁹, Stefan Vieths¹⁰, Montserrat Fernández-Rivas¹¹, Peter G Burney⁴, André C Knulst¹

Affiliations

¹ Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
² Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands ; Current affiliation: NIZO food research, Ede, The Netherlands.
³ Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands ; Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK.
⁴ Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK.
⁵ Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland.
⁶ Thermo Fisher Scientific, Uppsala, Sweden.
⁷ Institute of Food Research, Norwich Research Park, Colney, Norwich, NR4 7UA UK.
⁸ Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre, Manchester Institute of Biotechnology, The University of Manchester, Manchester, UK.
⁹ Department of Experimental Immunology and Department of Otorhinolaryngology, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands.
¹⁰ Division of Allergology, Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany.
¹¹ Allergy Department, Hospital Clinico San Carlos, IdISSC, Madrid, Spain.

Abstract

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.

Keywords: Adults; Community; DBPCFC; Food allergy; sIgE.