BACKGROUND IgE-mediated food allergy (FA) affects health-related quality of life, and may cause life-threatening reactions. Few studies characterizing adult FA patients have been reported, especially first ever reaction (FER) in adult-onset. OBJECTIVE We describe the characteristics of adult FA patients, especially FER and compare these characteristics between childhood- and adult-onset FA. METHODS A cross-sectional study of all adult patients visiting the Allergy Clinic, Siriraj Hospital at the outpatient department between January 2009 to December 2019 was conducted. Demographic, clinical data, and first reaction in life data were collected. Adult-onset was defined as ≥ 18 years old. RESULTS Of 711 patients visiting the clinic, 174 (24.4%) were FA with a median age of 31.0 years (interquartile range 24.0, 44.0 years); 29.3% were male. FA patients had significantly higher prevalence of sensitization to cockroach compared with non-FA patients (67.4% vs. 56.3%); p = 0.016). The three most common food triggers were shellfish (68.0%), wheat (28.7%), and fruit and vegetables (10.0%). Before diagnosis, 56.7% (97/171) experienced at least 1 food-related anaphylaxis. Of the 166 patients compared on age of onset, 127 (76.5%) were adult-onset. In FER, patients with adult-onset had significantly more reactions to fruit and vegetables, more respiratory system involvement, and more other systems involvement [OR 8.95 (1.13, 1157); p = 0.034; OR 3.15 (95%CI 1.30, 8.25), p = 0.011; OR 10.8 (1.35, 1404), p = 0.019, respectively]. In sensitivity analysis, the cardiovascular system involvement was also significantly more common [OR 2.78 (1.05, 9.15); p = 0.038]. CONCLUSIONS Shellfish was the most common trigger foods in adult FA patients. In FER, anaphylaxis was common for adult-onset. Adult-onset FA patients also had more respiratory, cardiovascular, and other systems involvements than childhood-onset ones. FA awareness, early diagnosis, and proper management are encouraged. Further studies on the adult-onset food allergic patients are required.

中文翻译：

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成人发病和儿童发病食物过敏的成年患者的患病率和特征。

背景 IgE 介导的食物过敏 (FA) 影响健康相关的生活质量，并可能引起危及生命的反应。很少有关于成人 FA 患者特征的研究报道，尤其是成人发病的首次反应 (FER)。目的 我们描述成年 FA 患者的特征，尤其是 FER，并比较儿童和成人发病的 FA 的这些特征。方法 对 2009 年 1 月至 2019 年 12 月期间到 Siriraj 医院过敏诊所门诊部就诊的所有成年患者进行横断面研究。收集人口统计、临床数据和生命中的第一反应数据。成人发病定义为≥ 18 岁。结果 711 名就诊患者中，174 名（24.4%）为 FA，中位年龄 31.0 岁（四分位距 24.0、44.0 岁）；29.3%为男性。与非 FA 患者相比，FA 患者对蟑螂过敏的发生率显着较高（67.4% vs. 56.3%）；p = 0.016）。三种最常见的食物触发因素是贝类（68.0%）、小麦（28.7%）以及水果和蔬菜（10.0%）。在诊断前，56.7% (97/171) 经历过至少 1 次与食物相关的过敏反应。在比较发病年龄的 166 名患者中，127 名 (76.5%) 为成人发病。在 FER 中，成人发病的患者对水果和蔬菜的反应明显更多，呼吸系统受累更多，其他系统受累也更多 [OR 8.95 (1.13, 1157)；OR 8.95 (1.13, 1157)；p = 0.034；或 3.15（95%CI 1.30，8.25），p = 0.011；或 10.8 (1.35, 1404)，p = 0.019，分别]。在敏感性分析中，心血管系统受累也明显更为常见[OR 2.78 (1.05, 9.15)；p = 0.038]。结论 贝类是成年 FA 患者最常见的触发食物。在 FER 中，过敏反应常见于成人发病。成人发病的 FA 患者也比儿童发病的患者有更多的呼吸、心血管和其他系统受累。鼓励 FA 意识、早期诊断和适当管理。需要对成人发病的食物过敏患者进行进一步的研究。