Food Allergy in Children with Inherited Epidermolysis Bullosa. The Results of the Observational Study

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Abstract

Background: Inherited epidermolysis bullosa (EB) refers to a group of rare inherited disorders characterized by severe damage of skin and in most patients — the gastrointestinal mucosa, what leads to a violation of skin and mucosal barrier properties in relation to allergens. However, the issues of food sensitization and food allergy in this category of patients have not been studied, and the study of this problem is important.

Aim: To evaluate the clinical manifestations of food allergy (FA) and IgE-response to food proteins in children with EB.

Methods: 82 patients with EB aged from 2 months to 16 years were entered this open non-randomized observational prospective study, including 20 patients with simple form of EB and 62 patients with dystrophic form of EB. We analyzed allergic history and clinical manifestations of the FA in all the patients. Every patient in this study underwent of determination of the concentration of total serum IgE and specific serum IgE to the most important food allergens, as well as to mixtures of household allergens in some cases (UniCAP System, Phadia AB). 

Results: Skin lesion in patients with EB masks allergic skin manifestations, causing a hypodiagnosis of the FA in this category of patients, which in turn leads to erroneous organization of nutritional support. FA (clinical manifestations) was identified in 20.7% of children with EB (in 10% of cases with simple form of EB and in 24.2% — in patients with dystrophic form of EB). Products containing cow’s milk protein, cereals, and eggs were identified as etiologic factors of FA in most cases. In the group of children with comorbidity FA and EB high and very high levels of total IgE (>1000 kUA / l) were detected most frequently. The main cause-significant allergens are cow’s milk proteins, cereals, eggs. 

Conclusions: Comorbidity with FA is high in patients with dystrophic form of EB. The main cause-significant allergens are cow’s milk proteins, cereals, eggs.

About the authors

S. G. Makarova

National Scientific and Practical Center of Children’s Health

Email: sm27@yandex.ru
ORCID iD: 0000-0002-3056-403X
Moscow Россия

L. S. Namazova-Baranova

National Scientific and Practical Center of Children’s Health;
Pirogov Russian National Research Medical University

Author for correspondence.
Email: namazova@nczd.ru
ORCID iD: 0000-0002-2209-7531
Moscow Россия

N. N. Murashkin

National Scientific and Practical Center of Children’s Health

Email: m_nn2001@mail.ru
ORCID iD: 0000-0003-2252-8570
Moscow Россия

E. A. Vishneva

National Scientific and Practical Center of Children’s Health

Email: vishneva@nczd.ru
ORCID iD: 0000-0001-7398-0562
Moscow Россия

R. V. Epishev

National Scientific and Practical Center of Children’s Health

Email: drepishev@gmail.com
ORCID iD: 0000-0002-4107-4642
Moscow Россия

T. R. Chumbadze

National Scientific and Practical Center of Children’s Health

Email: tamararob@rambler.ru
ORCID iD: 0000-0002-8172-5710
Moscow Россия

O. V. Kogevnikova

National Scientific and Practical Center of Children’s Health

Email: fd@nczd.ru
ORCID iD: 0000-0001-8562-6851
Moscow Россия

M. A. Snovskaya

National Scientific and Practical Center of Children’s Health

Email: snows@inbox.ru
ORCID iD: 0000-0002-5263-6743
Moscow Россия

O. A. Ereshko

National Scientific and Practical Center of Children’s Health;
I.M. Sechenov First Moscow State Medical University

Email: ksenya2005@inbox.ru
ORCID iD: 0000-0002-1650-652X

Аспирант ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова (Сеченовский Университет); младший научный сотрудник отдела профилактической педиатрии ФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава России 

SPIN-код: 3893-9946 

Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1

F. G. Balabekova

Republican Dermatovenerological Dispensary

Email: elkhan.suleymanov@gmail.com
ORCID iD: 0000-0001-5190-4315
Groznyj Россия

D. S. Yasakov

National Scientific and Practical Center of Children’s Health

Email: dmyasakov@mail.ru
ORCID iD: 0000-0003-1330-2828
Moscow Россия

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