Low frequency of IgE-mediated food hypersensitivity in mastocytosis
Abstract
Background Patients with mastocytosis have an increased risk for severe anaphylaxis, particularly to Hymenoptera venoms. These patients may also develop more often systemic hypersensitivity reactions to certain foods. However, this issue has not been systematically investigated.Objective To determine prevalence and severity of food hypersensitivity (FH) reactions among patients with clonal mast cell disorders (CMDs).Methods A retrospective study was conducted among 204 (age ≥18 years) consecutive patients who presented with confirmed CMD (170 with mastocytosis and 34 with monoclonal mast cell activation syndrome). All patients underwent thorough allergy workup where self-reported FH reactions were evaluated.Results The prevalence of self-reported FH was 20.6%. The frequency of immunologically mediated reactions was uncommon, because only 3.4% were confirmed by relevant history and IgE sensitization. Among patients with FH, 5 had severe anaphylaxis corresponding to an overall prevalence of 2.5%. Most symptoms were restricted to skin (86%), followed by gastrointestinal tract symptoms (45%)-similar to symptoms that occur in patients with mastocytosis also without food intake. Nuts, spicy foods, seafood, and alcohol were the most common incriminated elicitors. There was no significant difference between the groups regarding age, sex, atopic status, or IgE levels.Conclusions Anaphylaxis from foods in mastocytosis does exist and is severe, although foods are less frequent elicitors than insect venoms. Furthermore, the frequency of overall FH reactions is comparable with that in the general population and most reactions are mild, nonallergic, and unconfirmed. Consequently, our results do not support the elimination of any diet in patients with CMD without a history of FH.
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Patients with mixed MCAS are at high risk for developing recurrent life-threatening anaphylaxis, particularly after Hymenoptera stings, and possibly after exposure to food, drugs, and other allergens.
“thus, they are at high risk for developing recurrent life-threatening anaphylaxis, particularly after Hymenoptera stings, 23,100-102 but they might also be after exposure to food, drugs, and other allergens. 103-105”
From Selecting the Right Criteria and Proper Classification to Diagnose Mast Cell Activation Syndromes: A Critical Review (2021) · cites this paper as [103]
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- Authors
- Jarkvist, J., Brockow, K., & Gülen, T.
- Affiliations
- Karolinska University Hospital (SE)
- Technical University of Munich (DE)
- Corresponding author
- Gülen, Theo
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- The Journal of Allergy and Clinical Immunology In Practice
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- Published
- 2020-10
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- 8
- Issue
- 9
- Pages
- 3093-3101
- ISSN
- 2213-2198 (ISSN-L)
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- 41
- References
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- Topics
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Life Sciences › Immunology and Microbiology › Immunology › Mast cells and histamine
- Health Sciences › Medicine › Pharmacology › Drug-Induced Adverse Reactions
- Keywords
- mastocytosis, food allergy, IgE-mediated food allergy, clonal mast cell disorders, anaphylaxis, prevalence, IgE sensitization, mast cell activation, nuts, seafood, alcohol
- MeSH terms
- Adolescent, Anaphylaxis, Animals, Food Hypersensitivity, Humans, Hymenoptera, Hypersensitivity, Immunoglobulin E, Mast Cells, Mastocytosis, Retrospective Studies, Tryptases
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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