L F A De Swert1, P Cadot, J L Ceuppens. 1. Pediatric Allergy, Department of Pediatrics, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium.
Abstract
BACKGROUND: Allergy to heat stable potato proteins can cause severe allergic disease in children. OBJECTIVE: To study diagnostic criteria for allergy to cooked potatoes and to describe its clinical characteristics and natural history. METHODS: Thirty-six children, aged 4-36 months, with atopic symptoms and having a positive potato-CAP and/or skin prick test (SPT) were included. Potato allergy was documented by means of provocation, or elimination and reintroduction or an unequivocal clinical history. Potato-CAP and SPT with a commercial extract were evaluated for diagnostic performance. RESULTS: Presenting symptoms in children with proven potato allergy (n = 17) were eczema (16 of 17), gastrointestinal complaints (eight of 17), urticaria and/or angioedema (five of 17), wheezing/rhinitis (three of 17) and anaphylaxis (two of 17). Fifteen children had previously diagnosed cow's milk protein allergy and were egg-sensitized. Potato-CAP at cut-off >2 kU/l provided a 100% sensitivity and a 62.5% specificity for diagnosis of potato allergy, while a SPT score >/= 3 had a 100% sensitivity and a score >/= 4 had a 100% specificity. Tolerance to cooked potato was achieved in 80% of subjects at age 16-102 months. Of 12 subjects having reached the age of 3 years during the study, 10 were re-evaluated at age 3-6 years: seven of 10 subjects had developed clinical pollen allergy, compared with four of 18 atopic controls (P < 0.05). CONCLUSIONS: Potato-CAP and SPT at specific cut-off are valuable tools in the diagnosis of allergy to cooked potato. Most children with potato allergy develop tolerance at mean age of 4 years. Allergy to cooked potatoes is a risk factor for the development of pollen allergy.
BACKGROUND:Allergy to heat stable potato proteins can cause severe allergic disease in children. OBJECTIVE: To study diagnostic criteria for allergy to cooked potatoes and to describe its clinical characteristics and natural history. METHODS: Thirty-six children, aged 4-36 months, with atopic symptoms and having a positive potato-CAP and/or skin prick test (SPT) were included. Potatoallergy was documented by means of provocation, or elimination and reintroduction or an unequivocal clinical history. Potato-CAP and SPT with a commercial extract were evaluated for diagnostic performance. RESULTS: Presenting symptoms in children with proven potatoallergy (n = 17) were eczema (16 of 17), gastrointestinal complaints (eight of 17), urticaria and/or angioedema (five of 17), wheezing/rhinitis (three of 17) and anaphylaxis (two of 17). Fifteen children had previously diagnosed cow's milk protein allergy and were egg-sensitized. Potato-CAP at cut-off >2 kU/l provided a 100% sensitivity and a 62.5% specificity for diagnosis of potatoallergy, while a SPT score >/= 3 had a 100% sensitivity and a score >/= 4 had a 100% specificity. Tolerance to cooked potato was achieved in 80% of subjects at age 16-102 months. Of 12 subjects having reached the age of 3 years during the study, 10 were re-evaluated at age 3-6 years: seven of 10 subjects had developed clinical pollen allergy, compared with four of 18 atopic controls (P < 0.05). CONCLUSIONS:Potato-CAP and SPT at specific cut-off are valuable tools in the diagnosis of allergy to cooked potato. Most children with potatoallergy develop tolerance at mean age of 4 years. Allergy to cooked potatoes is a risk factor for the development of pollen allergy.