The following is a summary of “Celiac Disease Frequency Is Increased in IgE-Mediated Food Allergy and Could Affect Allergy Severity and Resolution,” published in the January 2023 issue of Gastroenterology by Lega, et al.
Severe Immunoglobulin E (IgE) -mediated food allergies (FA) had been linked to an increased prevalence of celiac disease (CeD). The observation has to be verified, and it was uncertain if CeD impacted the severity and resolution of FA. For a study, researchers sought to include estimating the prevalence of CeD in FA patients and determining if CeD impacted the severity of FA and oral tolerance.
Following referrals for allergen reintroduction, either to assess allergy remission or to begin oral immunotherapy (OIT), patients with FA were assessed for CeD and FA severity. The prevalence of CeD was the main result. The incidence of severe FA and the degree of clinical tolerance at study entry and final follow-up were secondary outcomes in patients with isolated FA as opposed to individuals with FA + CeD.
Included were 238 patients in all. About 15 patients (6.6%) who had previously been diagnosed with CeD and were following a gluten-free diet had their CeD confirmed. Compared to 88 patients with FA (42%), 12 patients with FA + CeD (80%) had severe FA (P = 0.006). In comparison to patients with FA (20.3 kU/L; IQR 2.9-72.7) (P< 0.001), individuals with FA + CeD had substantially higher median allergen-specific IgE levels at baseline [61.8 kU/L; interquartile range (IQR) 11.6–279.0]. Compared to 98 of 205 patients (48%) with FA, complete clinical tolerance was only seen in 1 of 15 patients (7%) with FA + CeD (P = 0.002).
CeD in individuals with FA and might influence the severity of FA and OIT response. In individuals with severe or chronic FA, CeD screening should be taken into consideration.