BACKGROUND: Soy allergy is very common, affecting approximately 0.4% of children. It is generally thought that the majority of children with soy allergy develop tolerance in early childhood; however, this has not been examined in a large cohort with soy allergy. OBJECTIVE: We sought to describe the natural history of soy allergy and identify predictors of oral tolerance/outgrowing soy allergy. METHODS: The records of patients with soy allergy seen in a tertiary referral clinic were reviewed. Data collected included soy allergy-related symptoms, history of other food allergies and atopic diseases, soy-specific IgE levels, peanut-specific IgE levels, and food challenge results. RESULTS: One hundred thirty-three patients were studied (96 male and 37 female patients). Eighty-five (64%) had asthma, 95 (71%) had allergic rhinitis, and 108 (85%) had atopic dermatitis. Eighty-eight percent had concomitant peanut allergy. The median age at the initial visit was 1 year (range, 2 months to 17.5 years); the median duration of follow-up was 5 years (range, 1-19 years). Kaplan-Meier analysis predicted resolution of soy allergy in 25% by age 4 years, 45% by age 6 years, and 69% by age 10 years. By age 6 years, 59% of children with a peak soy IgE level of less than 5 kU/L, 53% of children with a peak s-IgE level of 5 to 9.9 kU/L, 45% of children with a peak s-IgE level of 10 to 49.9 kU/L, and 18% of children with a peak s-IgE level of greater than 50 kU/L had outgrown soy allergy (P < .01 for trend). CONCLUSIONS: In this referral population approximately 50% of children with soy allergy outgrew their allergy by age 7 years. Absolute soy IgE levels were useful predictors of outgrowing soy allergy.
BACKGROUND: Soy allergy is very common, affecting approximately 0.4% of children. It is generally thought that the majority of children with soy allergy develop tolerance in early childhood; however, this has not been examined in a large cohort with soy allergy. OBJECTIVE: We sought to describe the natural history of soy allergy and identify predictors of oral tolerance/outgrowing soy allergy. METHODS: The records of patients with soy allergy seen in a tertiary referral clinic were reviewed. Data collected included soy allergy-related symptoms, history of other food allergies and atopic diseases, soy-specific IgE levels, peanut-specific IgE levels, and food challenge results. RESULTS: One hundred thirty-three patients were studied (96 male and 37 female patients). Eighty-five (64%) had asthma, 95 (71%) had allergic rhinitis, and 108 (85%) had atopic dermatitis. Eighty-eight percent had concomitant peanutallergy. The median age at the initial visit was 1 year (range, 2 months to 17.5 years); the median duration of follow-up was 5 years (range, 1-19 years). Kaplan-Meier analysis predicted resolution of soy allergy in 25% by age 4 years, 45% by age 6 years, and 69% by age 10 years. By age 6 years, 59% of children with a peak soy IgE level of less than 5 kU/L, 53% of children with a peak s-IgE level of 5 to 9.9 kU/L, 45% of children with a peak s-IgE level of 10 to 49.9 kU/L, and 18% of children with a peak s-IgE level of greater than 50 kU/L had outgrown soy allergy (P < .01 for trend). CONCLUSIONS: In this referral population approximately 50% of children with soy allergy outgrew their allergy by age 7 years. Absolute soy IgE levels were useful predictors of outgrowing soy allergy.
Authors: Joshua A Boyce; Amal Assa'ad; A Wesley Burks; Stacie M Jones; Hugh A Sampson; Robert A Wood; Marshall Plaut; Susan F Cooper; Matthew J Fenton; S Hasan Arshad; Sami L Bahna; Lisa A Beck; Carol Byrd-Bredbenner; Carlos A Camargo; Lawrence Eichenfield; Glenn T Furuta; Jon M Hanifin; Carol Jones; Monica Kraft; Bruce D Levy; Phil Lieberman; Stefano Luccioli; Kathleen M McCall; Lynda C Schneider; Ronald A Simon; F Estelle R Simons; Stephen J Teach; Barbara P Yawn; Julie M Schwaninger Journal: J Allergy Clin Immunol Date: 2010-12 Impact factor: 10.793