Jessica P Rajan1, Ronald A Simon2, John V Bosso3. 1. Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, Calif. Electronic address: rajan.jessica@scrippshealth.org. 2. Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, Calif. 3. Allergy & Asthma Consultants of Rockland and Bergen, West Nyack, NY.
Abstract
BACKGROUND: Chronic idiopathic urticaria (CIU) is defined as the presence of urticaria most days of the week for a period of 6 weeks or longer. There have been reports of food additive sensitivity in CIU previously, but the prevalence has not been precisely determined. OBJECTIVE: To determine the prevalence of reactions to food and drug additives in patients with CIU. METHODS: We challenged 100 patients in our allergy/immunology division with CIU to the 11 additives most commonly associated with reactions: tartrazine (FD&C Yellow 5), potassium metabisulfite, monosodium glutamate, aspartame, sodium benzoate, methyl paraben, butylated hydroxy anisole, butylated hydroxy toluene, FD&C Yellow 6, sodium nitrate, sodium nitrite. All of the patients had a history of CIU for longer than 6 weeks, and 43 reported possible history of food or drug additive sensitivity. Single-blind challenges to all of the additives were performed in the clinic and skin scores were recorded. Subjects with positive challenge tests underwent double-blind placebo controlled challenges. RESULTS: Of 100 subjects, only 2 had a positive urticarial response on single-blind challenge. Neither of these patients had a positive urticarial response on double-blind placebo-controlled challenge. There were no gastrointestinal, respiratory, or other symptom, and no patients reported late reactions. CONCLUSION: We were able to conclude, with 95% confidence intervals that sensitivity to any of the 11 food and drug additives occurs in fewer than 1% of patients with CIU. Food and drug additives appear to be a rare cause of CIU, and avoidance is not recommended.
BACKGROUND:Chronic idiopathic urticaria (CIU) is defined as the presence of urticaria most days of the week for a period of 6 weeks or longer. There have been reports of food additive sensitivity in CIU previously, but the prevalence has not been precisely determined. OBJECTIVE: To determine the prevalence of reactions to food and drug additives in patients with CIU. METHODS: We challenged 100 patients in our allergy/immunology division with CIU to the 11 additives most commonly associated with reactions: tartrazine (FD&C Yellow 5), potassium metabisulfite, monosodium glutamate, aspartame, sodium benzoate, methyl paraben, butylated hydroxy anisole, butylated hydroxy toluene, FD&C Yellow 6, sodium nitrate, sodium nitrite. All of the patients had a history of CIU for longer than 6 weeks, and 43 reported possible history of food or drug additive sensitivity. Single-blind challenges to all of the additives were performed in the clinic and skin scores were recorded. Subjects with positive challenge tests underwent double-blind placebo controlled challenges. RESULTS: Of 100 subjects, only 2 had a positive urticarial response on single-blind challenge. Neither of these patients had a positive urticarial response on double-blind placebo-controlled challenge. There were no gastrointestinal, respiratory, or other symptom, and no patients reported late reactions. CONCLUSION: We were able to conclude, with 95% confidence intervals that sensitivity to any of the 11 food and drug additives occurs in fewer than 1% of patients with CIU. Food and drug additives appear to be a rare cause of CIU, and avoidance is not recommended.
Authors: M Ferrer; J Bartra; A Giménez-Arnau; I Jauregui; M Labrador-Horrillo; J Ortiz de Frutos; J F Silvestre; J Sastre; M Velasco; A Valero Journal: Clin Exp Allergy Date: 2015-04 Impact factor: 5.018
Authors: Stephanie K Meyer; Philip M E Probert; Anne F Lakey; Andrew R Axon; Alistair C Leitch; Faith M Williams; Paul A Jowsey; Peter G Blain; George E N Kass; Matthew C Wright Journal: Toxicol Lett Date: 2017-03-27 Impact factor: 4.372