Long Term Follow-up of Sesame Allergy in children

Objective: to evaluate the incidence of tolerance developed over the follow-up period via phone surveys. In addition, to compare the patients with sesame allergy and tolerant patients.

Study design and patients: In a descriptive cross-sectional study, we reviewed 2,450 visits to the allergy clinic in Wolfson medical center between the years 2012-2016; fifty of these included patients examined for sesame allergy. Thirty-nine patients\parents agreed to participate in our study and completed the phone questionnaire. Data including the age of the child at the time of the first visit, other food allergies, clinical manifestation of food allergy and whether a diagnostic test was performed [skin prick test (SPT), sesame specific IgE and oral food challenge(OFC)].

Results: Thirty-nine patients were surveyed. The mean age was 10.1 (±3.4) years, twenty-nine were male (74%), thirty-five (90%) patients had history of an allergic reaction to sesame prior to diagnosis and during the follow-up period. The allergic reactions to sesame were mucocutaneous in 30 (77%) patients; few patients had respiratory and gastrointestinal reactions (23% and 15% respectively). Most patients had other food allergies (82%) and twenty-five (64%) patients had other atopic disease. The diagnosis of sesame allergy was based on SPT and a clinical history in 35 (90%) patients, sesame sIgE was performed on nine (23%) patients. 20 (51%) underwent OFC. Of the 39 patients, 25 (64%) reported tolerance to sesame, while 19 (36%) continued to avoid all sesame products. The mean length of follow-up was 9 years (±3 years), ranging 5-18 years.

The sesame allergic and tolerant patients were compared, the allergic patients had more respiratory and gastrointestinal symptoms than the tolerant group with a statistical significance, Anaphylaxis occurred mainly in non-tolerant patients, although no statistical significance was demonstrated.

Discussion: the higher rate of tolerance development demonstrated in our study might reflect the longer follow-up period. These results might indicate that the long-term prognosis of sesame allergic patients is better that once believed, but remain to be expanded upon with larger prospective trials.