Clinical and immunological characteristics of food allergy in different forms of inherited epidermolysis bullosa

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Abstract

BACKGROUND: Inherited epidermolysis bullosa is a severe orphan hereditary disease with a predominant lesion of the skin and mucous membranes. The study of the comorbid background, including food allergies, remains an urgent issue, given the difficulties that often arise in the treatment and formation of the diet in this category of patients.

AIM: to assess the frequency and nature of food allergies in children with inherited epidermolysis bullosa.

MATERIALS AND METHODS: An open single-center randomized observational retrospective and prospective study included 165 patients aged 2 months to 17 years with an inherited epidermolysis bullosa. All patients were evaluated for an allergic history, determination of the levels of total IgE and allergen-specific serum IgE to the most significant food allergens (UniCAP System, Thermo Fisher Scientific), if necessary, a diagnostic elimination diet and diagnostic product administration were prescribed, based on the data obtained, the diagnosis of food allergy was confirmed or excluded.

RESULTS: Among children suffering from inherited epidermolysis bullosa, confirmed food allergy was 13.9% of cases (in 13.4% in the group of children with dystrophic form of the disease, 15.2% in the group of children with a simple form of the disease). The main manifestations of food allergy in this cohort of patients were skin symptoms. Cow’s milk proteins were the most frequent etiological factor of food allergy (78.3%). Most children with food allergies had a high level of total IgE (87.5%). In children with non-IgE mediated form, high levels of total IgE were detected in 25% of cases, while these children were characterized by a severe course of the underlying disease or the presence of concomitant atopic dermatitis. Burdened heredity for allergic diseases turned out to be more typical for children with an IgE-mediated form of food allergy from the group of simple epidermolysis bullosa.

CONCLUSION: Early detection of food allergies in children with inherited epidermolysis bullosa, as an aggravating factor in the course of the underlying disease, is necessary to optimize the tactics of dietary support for patients with inherited epidermolysis bullosa.

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About the authors

Albina A. Galimova

National Medical Research Center for Children’s Health

Author for correspondence.
Email: albina86@yandex.ru
ORCID iD: 0000-0002-6701-3872
SPIN-code: 2960-6185
Russian Federation, Moscow

Svetlana G. Makarova

National Medical Research Center for Children’s Health; Lomonosov Moscow State University

Email: sm27@yandex.ru
ORCID iD: 0000-0002-3056-403X
SPIN-code: 2094-2840

MD, Dr. Sci. (Med.)

Russian Federation, Moscow; Moscow

Nikolay N. Murashkin

National Medical Research Center for Children’s Health; The First Sechenov Moscow State Medical University (Sechenov University); Central State Medical Academy of Department of Presidential Affairs

Email: m_nn2001@mail.ru
ORCID iD: 0000-0003-2252-8570
SPIN-code: 5906-9724

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow; Moscow; Moscow

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Supplementary files

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2. Fig. 1. The frequency of detection of allergen-specific IgE the most common allergens in all children with inherited epidermolysis bullosa: a ― dystrophic form; b ― simple form.

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3. Fig. 2. Frequency of detection of allergen-specific IgE to causally significant food allergens, %. Here and in Fig. 3: ДБЭ ― dystrophic epidermolysis bullosa; ПБЭ ― simple epidermolysis bullosa.

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4. Fig. 3. Burdened heredity for allergic diseases in children, depending on the forms of inherited epidermolysis bullosa and the form of the food allergy.

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