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 Pe diatrics 2 Department in Casablanca. Patient selection was based on a histo ry of at least two episodes of respiratory difficulties or wheezing followi ng ingestion of a specific food. Prick-tests for extracts of the correspond ing 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 seve n 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 mod erate asthma and one intermittent asthma. The offending foods were shrimp i n three cases, snails in two, sesame seed in two, peanuts in three, pistach ios 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 la bial challenge was positive in three cases. Management consisted of elimina tion of the offending food allergen and treatment of the asthma. During fol low-up, recurrences were recorded in three patients following intentional o r unintentional ingestion of the allergen. Asthma "caused by foods" is rare and of unclear pathophysiology. Documentation of the causal relationship i s difficult to obtain and requires tests that can be hazardous. However, pr oof that the food allergen triggers asthma attacks should be obtained to av oid unnecessary dietary restrictions in growing children.