Quality of Life is Lower in Adults Labeled with Childhood-Onset Compared to Adult-Onset Food Allergy

Abstract BACKGROUND IgE-mediated food allergy (FA) affects children and adults with variable age of onset. Phenotype and quality of life (QoL) differences between childhood-onset FA (COFA) and adult-onset FA (AOFA) are not known. OBJECTIVE To identify phenotypic and QoL differences between AOFA and COFA. METHODS: A cross-sectional study of adults (≥18 years old) seen at Northwestern Memorial HealthCare clinics between 2002-2017 with an ICD-9/ICD-10 diagnosis of FA were identified. Subjects were completed a FA history survey and Food Allergy Quality of Life Questionnaire (FAQLQ). FA characteristics and QoL scores were compared between groups. RESULTS Among 294 consented subjects, 202 had a clinical history consistent with labeled IgE-mediated FA. The onset of FA symptoms occurred before age 18 years (COFA) in 80 subjects, and after age 18 years in 122 (AOFA) subjects. Shellfish reactions were most common in AOFA labeled subjects (28%) while tree nut reactions were the most common in COFA labeled subjects (55%) compared to other triggers. Hives (68% vs. 52%, P=0.03), facial swelling (69% vs 50%, P=0.009), wheezing (56% vs 29%, P