Asthma, Eczema, and Food Allergy in Children Following Liver Transplantation

Runar Almaas; Svanhildur Haflidadottir; Runa Helen Kaldestad; Iren Lindbak Matthews

doi:10.1016/j.jpeds.2018.08.050

Asthma, Eczema, and Food Allergy in Children Following Liver Transplantation

J Pediatr. 2019 Jan:204:263-269. doi: 10.1016/j.jpeds.2018.08.050. Epub 2018 Sep 27.

Authors

Runar Almaas¹, Svanhildur Haflidadottir², Runa Helen Kaldestad³, Iren Lindbak Matthews³

Affiliations

¹ Department of Pediatric Research, Division of Pediatric and Adolescent Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway. Electronic address: runar.almaas@ous-hf.no.
² Department of Pediatric Research, Division of Pediatric and Adolescent Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
³ Division of Pediatric and Adolescent Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway.

PMID: 30270158
DOI: 10.1016/j.jpeds.2018.08.050

Abstract

Objectives: To describe the prevalence and the relationship between asthma, eczema, food allergy, and rhinitis in children after liver transplantation.

Study design: Children who were liver transplant recipients were investigated to assess whether the high prevalence of food allergies was accompanied by eczema, rhinitis, and asthma. Furthermore, we included 56 children with chronic liver disease to explore the risk of allergy, eczema, and asthma in this group.

Results: After liver transplantation, children had higher prevalence of allergic reactions to food as compared with children with chronic liver disease (P < .001). Current asthma (P = .04) and eczema (P < .02) were observed more frequently in transplanted children as compared with children with chronic liver disease. For transplanted children who had ever received tacrolimus the relative risk (RR) of asthma was 1.7 (95% CI, 1.2-2.4; P = .02) as compared with children with chronic liver disease. Transplanted children with asthma had higher rates of sensitization to food allergens than those without asthma (RR, 3.6; 95% CI, 1.3-10.3; P = .01). The most frequent food allergens associated with asthma in transplanted children were milk (RR for asthma, 3.9; 95% CI, 1.6-9.4; P < .01), eggs (RR, 2.9; 95% CI, 1.2-7.0; P = .03), and peanuts (RR, 3.7; 95% CI, 1.6-8.3; P < .01). Food allergies occurred earlier than asthma, at 1.5 years after transplantation (IQR, 0.5-3.0 years) vs 2.5 years after transplantation (IQR, 1.0-4.5 years; P < .05). Food allergies were also associated with eczema, but not with sensitization to aero-allergens or rhinitis.

Conclusions: The high risk of food allergies in children who were liver transplant recipients was associated with eczema and asthma, but not rhinitis. The most frequent food allergens associated with asthma were milk, eggs, and peanuts.

Keywords: asthma; children; complication; food allergy; immunosuppression; liver disease; liver transplantation; lung function; spirometry; tacrolimus.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Asthma / epidemiology*
Asthma / etiology
Child
Child, Preschool
Cross-Sectional Studies
Eczema / epidemiology*
Eczema / etiology
End Stage Liver Disease / complications*
End Stage Liver Disease / surgery
Female
Food Hypersensitivity / epidemiology*
Food Hypersensitivity / etiology
Humans
Immunosuppressive Agents / adverse effects
Infant
Liver Transplantation / adverse effects*
Male
Prevalence
Respiratory Function Tests / methods
Rhinitis / epidemiology
Rhinitis / etiology
Risk Factors

Substances

Immunosuppressive Agents