oa Current Allergy & Clinical Immunology - Clinical characteristics of - and predictive diagnostic factors for - sesame seed allergy in food-allergic children : original research

Volume 26, Issue 2
  • ISSN : 1609-3607



Sesame-seed allergy (SSA) is common in children. Our aim was to identify clinical correlations between SSA and other food allergies and predictive factors associated with SSA with regard to skin prick testing (SPT) and specific IgE (Sp-IgE) testing in children.

Data were collected from food allergy questionnaires returned by 79 patients in a tertiary paediatric allergy service; additional clinical information was obtained from the patient database.
Of 79 patients, 42 (53.2%) met the study definition for SSA. As compared with children without SSA, those with SSA had a significant association with allergy to other seeds (unadjusted odds ratio (OR) 5.42, 95% confidence interval (CI) 1.53-19.17, =0.009), especially poppy seed (7/42 (16.7%)). SSA was also significantly associated with tree-nut allergies (unadjusted OR 7.50, 95% CI 1.51-37.28, =0.014) but not peanut allergy. A high sensitivity and specificity for determining SSA could be obtained using a SPT cut-off of 2 mm (sensitivity 70.1% and specificity 73.1%) and a Sp-IgE level cutoff of 1.7 IU/ml (sensitivity 76.5% and specificity 84.6%). SSA had been outgrown in 8/79 (10.1%) of the children who at the time of the questionnaire did not have SSA. Low amounts of sesame ingestion (median 0.43 g (range 0-19.71 g)) were tolerated by 7/42 (16.7%) SSA children; the majority of allergic reactions occurred to foods containing high amounts of sesame protein.
Sesame-seed-allergic children are at risk of allergies to other seeds and tree nuts. In this cohort, sesame Sp-IgE testing performed well, and better than SPT, at low levels, for the diagnosis of SSA. Similar studies are required in a general population to provide diagnostic cut-off levels that are applicable to unselected children.

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