ADVERSE REACTIONS TO FOOD-ADDITIVES IN CHILDREN WITH ATOPIC SYMPTOMS

In a multicenter study conducted at four Danish hospital pediatric dep artments, the parents of 472 consecutive children were informed of thi s project to determine the incidence of intolerance of food additives among children referred to an allergy clinic with symptoms of asthma, atopic dermatitis, rhinitis, or urticaria. After a 2-week period on an additive-free diet, the children were challenged with the eliminated additives. The food additives investigated were coloring agents, prese rvatives, citric acid, and flavoring agents. Carbonated ''lemonade'' c ontaining the dissolved additives was used for the open challenge. Two doses were used: a low dose and a 10-fold higher dose. Gelatin capsul es were used for a double-blind challenge. The children were 4-15 year s old, and they were attending an outpatient pediatric clinic for the first time. Of the 379 patients who entered the study, 44 were exclude d and 335 were subjected to open challenge. A total of 23 children dev eloped positive reactions after the open challenge. Sixteen of these p atients accepted the double-blind challenge, and six showed a positive reaction to preservatives (atopic dermatitis, asthma, rhinitis), colo ring agents (atopic dermatitis, asthma, urticaria, gastrointestinal sy mptoms), and citric acid (atopic dermatitis, gastrointestinal symptoms ). The incidence of intolerance of food additives was 2% (6/335), as b ased on the double-blind challenge, and 7% (23/335), as based on the o pen challenge with lemonade. Children with atopic skin symptoms had a statistically increased risk of a positive reaction. This may have con sequences for the future clinical investigation of children with atopi c cutaneous symptoms.