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 the prevalence and phenotype of IgE–mediated FA in CF. Objective: To determine the prevalence and characteristics of pediatric FA in CF. Methods: We conducted a retrospective pediatric cohort study using the CF 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 on the basis of a priori criteria, including medical history, testing results, and management. The estimated prevalence was calculated as a percentage and compared with the most recently reported pediatric FA prevalence in the United States. Results: Among 289 patients (51.21% male sex, median age = 12.40 years), 11 (3.81%, 95% CI 1.91-6.71) had at least 1 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 = .015). Male patients with CF (6.08% vs 1.42%, P = .038) and patients without pancreatic enzyme replacement (9.09% vs 2.25%, P = .020) had a higher prevalence of convincing FA. Conclusion: Our study of pediatric patients with CF found a lower prevalence of FA compared with the general pediatric population in the United States. Stringent criteria should be used when labeling patients with CF who have FA to minimize overdiagnosis. Further studies are needed to investigate whether CF could potentially be protective against the development of FA.