Akademik Veri Yönetim Sistemi
Allergologia et Immunopathologia, cilt.54, ss.10-17, 2026 (SCI-Expanded, Scopus)
Background: Oral food challenges (OFCs) are the gold standard for diagnosing IgE-mediated food allergies in children, although they carry an inherent risk of inducing allergic reactions, including anaphylaxis. This study examined clinical outcomes and predictors of positive OFC results in a pediatric cohort from a region with high exposure to sesame and tree nuts. Methods: We retrospectively analyzed 310 OFCs in 211 children (median age: 21 months [IQR: 14–37.3]) at a tertiary pediatric allergy center from January 1 to December 31, 2023. Reaction patterns and predictors of OFC positivity, including age, sex, initial reaction type, skin prick test (SPT) wheal size, and serum-specific IgE (sIgE) levels, were evaluated. Results: OFC positivity occurred in 12.3% (38/310) of the challenges, and was most commonly triggered by milk or dairy products (44.7%), tree nuts (23.6%), and eggs (18.4%). Cutaneous symptoms predominated (94.7%), followed by gastrointestinal (10.6%) and respiratory (7.9%) manifestations. Anaphylaxis occurred in 13.2% (5/38) of the positive OFCs. Positive OFC patients were older (P = 0.009), had longer follow-up (P = 0.046), and were more likely to have presented with urticaria (P < 0.001) or anaphylaxis (P < 0.001). Multivariate logistic regression identified milk or dairy products (OR: 3.326, 95% CI: 1.437–7.702, P = 0.005), sesame (OR: 7.022, 95% CI: 1.194–41.311, P = 0.031), and hazelnut (OR: 11.286, 95% CI: 3.858–33.017, P < 0.001) as independent predictors of OFC positivity. Conclusion: OFC positivity was 12.3%, and was predominantly triggered by milk, tree nuts, and eggs. Severe reactions, including anaphylaxis, occurred despite low sIgE and SPT values, confirming the limited utility of sensitization markers in predicting clinical reactivity. Older age, longer follow-up, history of urticaria or anaphylaxis, and challenges with milk, sesame, or hazelnut were independently associated with positive OFCs. These results underscore the critical role of risk-stratified, closely monitored OFCs in ensuring diagnostic accuracy and guiding safe, personalized management in pediatric IgE-mediated food allergy.