IgE food sensitizations amongst children with Atopic Eczema

Background: Despite an increasing body of clinical and laboratory evidence suggesting that food hypersensitivity plays a pathogenic role in Atopic Eczema (AE) in a subset of patients, whether IgE food sensitization has any impact on the clinical severity of AE is not clearly established. Objective: To investigate the association between the severity of eczema and immunoglobulin E mediated food sensitization among atopic eczema children in Hong Kong. Study Design: A retrospective chart review study of total 77 atopic eczema cases (age 0-14 years) was carried out. The eczema severity scores (three item severity scores TIS), skin prick test results (wheal diameters), and food specific immunoglobulin E levels, clinician diagnosed food allergy were recorded as main outcome measures. Immunoglobulin E mediated food sensitization was diagnosed when the skin prick test resulted in a wheal diameter of greater than 3 mm compared with the negative control and serum food specific immunoglobulin E level greater than 0.35 ku/L. Result: Overall IgE food sensitization to at least 1 food by either skin prick test or blood test was 81.8%. Eczema severity by TIS was not correlated with the frequency of immunoglobulin E mediated food sensitizations (p-value=0.1346). More than 60% of children in this study developed eczema before 6 months old and this early onset eczema group was highly associated with egg, cow's milk and fish sensitizations (p-value=0.0179, 0.015, and 0.0468 respectively). A positive association was found between the eczema severity and serum total IgE level (p-value=0.002). Conclusion: IgE food sensitization is very common in this small cohort of Hong Kong children with atopic eczema. Most eczema children with or without clinical history of food reactions have shown positive SPT and CAP-FEIA, or one of the two. Severity of atopic eczema is positively associated with the levels of total IgE. It was not shown that any particular food sensitization was associated with severity of eczema.