Food allergies and asthma in children.

The role of food allergies as triggers for asthma attacks was evaluated in 12 pediatric patients seen between October 1995 and November 1997 at the Pediatrics 2 Department in Casablanca. Patient selection was based on a history of at least two episodes of respiratory difficulties or wheezing following ingestion of a specific food. Prick-tests for extracts of the corresponding food allergen or the native food were done in all 12 cases, as well as an inhospital nasal or labial challenge test. There were five boys and seven girls with an age range of six months to 12 years. All 12 patients had a personal history of atopy and ten a family history of atopy. Eleven had moderate asthma and one intermittent asthma. The offending foods were shrimp in three cases, snails in two, sesame seed in two, peanuts in three, pistachios in three, and cow's milk in four. The prick test was positive in all 12 cases. Specific IgE titers were elevated in eight cases. An oral challenge test was done in two patients and was followed by wheezing in both. The labial challenge was positive in three cases. Management consisted of elimination of the offending food allergen and treatment of the asthma. During follow-up, recurrences were recorded in three patients following intentional or unintentional ingestion of the allergen. Asthma "caused by foods" is rare and of unclear pathophysiology. Documentation of the causal relationship is difficult to obtain and requires tests that can be hazardous. However, proof that the food allergen triggers asthma attacks should be obtained to avoid unnecessary dietary restrictions in growing children.