Prevalence and Phenotype of Food Allergy in Children with Cystic Fibrosis.

Abstract

Background: Nonspecific gastrointestinal symptoms associated with cystic fibrosis (CF) may be misdiagnosed as food allergy (FA). There is a paucity of data regarding prevalence and phenotype of IgE-mediated FA in CF.

Objective: We aimed to determine the prevalence and characteristics of pediatric FA in CF.

Methods: We conducted a retrospective pediatric cohort study using the Cystic Fibrosis Foundation Registries and electronic medical records from [redacted names A and B]. Demographic, biometric, and medical information were collected, and individuals suspected of having FA were identified through multiple inclusion criteria. A convincing FA diagnosis was established based on a priori criteria including medical history, testing results, and management. Estimated prevalence was calculated as a percentage and compared to the most recently reported pediatric FA prevalence in the United States (US).

Results: Among 289 patients (51.21% male, median age=12.40 years), 11 (3.81%, 95% confidence interval [CI] 1.91-6.71) had at least one convincing FA, yielding a smaller prevalence than the most recent estimate in the US pediatric population (7.60%, 95% CI 7.10-8.10, p=0.015). Male CF patients (6.08% versus 1.42%, p=0.038) and patients without pancreatic enzyme replacement (9.09% versus 2.25%, p=0.020) had higher prevalence of convincing FA.

Conclusion: Our study of pediatric CF patients found a lower prevalence of FA compared to the general pediatric population in the US. Stringent criteria should be used when labeling CF patients with FA to minimize overdiagnosis. Further studies are needed to investigate if CF could potentially be protective against the development of FA.