Sesame Allergy: Characteristics and Outcomes
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY(2022)
Abstract
Sesame is the 9th common food allergen in the US. The course of sesame allergy requires further evaluation. Using an I2B2 search, we identified sesame-allergic patients who were evaluated at the Allergy Program at Boston Children’s Hospital (BCH). A retrospective chart review was performed extracting information about demographics, sesame skin-prick test (SPT) and specific-IgE, food challenge outcome, and atopic disease diagnosis. 1,394 patients were included (mean follow-up 4 years). 38.1% were females and 61.9% males. Mean age at diagnosis was 4.2 years, and most common reason for testing (53%) was other food allergy. 94% had a tree nut and/or peanut allergy diagnosis. Only 37.2% of all patients had at least 1 confirmed allergic reaction while only 9.8% of them had anaphylaxis to sesame.67% of patients had allergic rhinitis and 73% had eczema. Resolution was documented in only 8.4% of patients and was negatively associated with an ongoing history of peanut (p<0.001) or tree nut allergy (p<0.001) or a history of sesame reactions (p=0.035).Most recent SPT≥8mm wheal was associated with history of allergic reaction (p<0.001), history of anaphylaxis to sesame (p<0.001) and eczema (p=0.016). Most recent sesame IgE ≥10kU/L was associated with use of epinephrine (p=0.022), emergency visits (p=0.031), allergic rhinitis (p=0.006), eczema (p=0.001), and asthma (p=0.013). This is the largest retrospective study evaluating sesame-allergic patients. More than half were evaluated because of other food allergies and only about a third only had an allergic reaction to sesame. Patients without peanut and/or tree nut allergies are at higher odd of resolution.
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Key words
Sesame
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