IntroductionPatients with food allergies need personalized information on their risk of reaction in “real‐life” situations. This multicentric study aimed to investigate the link during accidental reactions between the nature and amount of food allergens consumed in “real‐life situation” and the severity of the symptoms.MethodsPatients were prospectively recruited from December 1, 2020, to December 31, 2021, at the emergency departments in the Geneva University Hospitals and local pediatric emergency facilities, through an allergy outpatient clinic, at school and daycare facilities and trough their primary care physicians. Medical history of patients presenting reactions suggestive with immediate food allergy and suspected food samples were collected. Allergy diagnostic tests were retrospectively and prospectively collected. The samples were analyzed for their allergen content.ResultsWe recruited 147 subjects with an accidental immediate‐type allergic reaction to a food. We were able to collect 115 reaction‐eliciting food samples allowing to quantify the allergen amount causing the reaction, as well as correlating this amount to the severity of the reaction. Children represented a large part of the reactors, and most reactions were to common food allergens such as tree nuts, cow's milk as well as peanuts and hen's egg. Reactions were mostly to prepackaged foods and seven reactions were to products with precautionary allergy labeling, or without labelling to the eliciting allergen. Reactions were of various degrees of severity, and independent to the amount of allergen ingested.DiscussionThe severity of reactions did not show a direct correlation with allergen quantity, emphasizing individual sensitivity. Some reactions occurred with allergen amounts significantly below the legal limit for mandatory labelling of 1 g/kg (1000 ppm) in Switzerland. The study also highlighted considerable variability in allergen concentrations in foods labeled with possible “contaminations” or “traces”. These findings raise questions about the accuracy of allergen labeling and regulations in Switzerland.

中文翻译：

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在现实世界环境中，过敏反应的严重程度与食物的诱发量无关


引言食物过敏患者需要有关他们在“现实生活”情况下的反应风险的个性化信息。这项多中心研究旨在调查“现实生活情况”中食用的食物过敏原的性质和数量与症状严重程度之间意外反应之间的联系。方法前瞻性招募患者于 2020 年 12 月 1 日至 2021 年 12 月 31 日，在日内瓦大学医院急诊科和当地儿科急诊机构、过敏门诊、学校和日托机构以及他们的初级保健医生。收集了患者出现提示即刻食物过敏反应和可疑食物样本的病史。回顾性和前瞻性收集过敏诊断试验。分析样品的过敏原含量。结果我们招募了 147 名对食物发生意外速发型过敏反应的受试者。我们能够收集 115 个引起反应的食物样品，从而量化引起反应的过敏原量，并将该量与反应的严重程度相关联。儿童占反应器的很大一部分，大多数反应是对常见的食物过敏原，如坚果、牛奶以及花生和鸡蛋。反应主要针对预包装食品，7 例反应针对带有预防性过敏标签或没有标签的诱发过敏原的产品。反应的严重程度不同，与摄入的过敏原量无关。讨论反应的严重程度与过敏原数量没有直接相关性，强调了个体敏感性。 在瑞士，过敏原含量明显低于法定限值 1 g/kg （1000 ppm） 时，发生了一些反应。该研究还强调了标有可能“污染”或“痕量”的食品中过敏原浓度的巨大差异。这些发现对瑞士过敏原标签和法规的准确性提出了质疑。