Food sensitization and food allergy in allergic Thai patients from a tertiary care center in Thailand.

BACKGROUND: A skin prick test (SPT) and food challenge test (OFC) are useful in identification of food sensitization and food allergy. OBJECTIVE: To evaluate food allergen sensitization by SPT and food allergy by OFC in allergic Thai patients. METHODS: SPTs for common food allergens were performed on allergic patients at Siriraj Hospital, Bangkok, Thailand, from 2011 to 2015. An OFC was performed in positive food SPT patients with informed consent. RESULTS: SPTs to food were positive in 539 (20%) out of 2,678 allergic patients (73.8% were < 10 years old). Crab was the most common sensitized food in each year of the study period. In patients aged < 1 year, the most common sensitized foods were egg white (23.8%) and wheat (22.2%), while shrimp was for patients aged > 10 years (25%). A positive OFC was found in 29 (26.1%) out of the 111 OFCs performed (9.1% in patients with asthma, 28.6% in allergic rhinitis and 26.3% in food allergy). Positive OFCs were found for 60% of the crab, 35.7% of the egg yolk, and 31% of the cow's milk OFCs. Compared to OFC, SPT showed high specificity (71%-100%) but low sensitivity (0%-40%). The percentage of sensitization to egg white, egg yolk, wheat, soy, and peanut significantly increased (p < 0.05) from 2011 to 2015. CONCLUSION: The sensitization to egg white, egg yolk, wheat, soy, and peanut significantly increased and crab was the most common sensitized food. Food allergy in patients with allergic rhinitis was as common as in patients diagnosed food allergy.

Clinical Characteristics of Allergy to Hymenoptera Stings.

OBJECTIVE: The purpose of this study was to evaluate the clinical characteristics of allergy to stings from the Hymenoptera order of insects in a hospital in Thailand. METHODS: A descriptive retrospective analytical study was carried out in inpatients and outpatients suffering from Hymenoptera stings from 2009 to 2013 in Siriraj Hospital. RESULTS: Medical records of 386 patients with an allergy to Hymenoptera stings were evaluated. Anaphylaxis was more common in patients younger than 15 years, who comprised 22.3% of patients in this study. The most common sting type was from wasps (58.3%). Eighty-five percent of patients sought medical treatment less than 24 hours after being stung. A systemic reaction and anaphylaxis were found in 9.9% and 4.4% of subjects, respectively. In 17 patients with anaphylaxis, only 11 patients (64.7%) received an epinephrine (adrenaline) injection as treatment, and only 8 (47.1%) received epinephrine autoinjectors or epinephrine-prefilled syringes to prevent a possible subsequent severe reaction. Significantly more patients younger than 15 years received epinephrine for prevention of an allergic reaction than did those older than 15 years (87.5% vs 11.7%, P < 0.001). Antibiotics were given to 43.0% of patients. CONCLUSIONS: Anaphylaxis from Hymenoptera stings was more common in children than in adults. Only half of the patients visited the emergency room within 1 hour of being stung. Overuse of antibiotics and underuse of epinephrine were found. More information about Hymenoptera stings should be provided to the public, and the use of epinephrine should be encouraged in the case of severe reactions and anaphylaxis.