Children with IgE-mediated allergies have a lower risk of complicated appendicitis, according to new research published in the journal JAMA Pediatrics.
In the cohort study of 605 children undergoing appendectomy, those with IgE-mediated allergy had a 3 times lower risk of complicated appendicitis compared with those without allergy. This low magnification micrograph shows acute appendicitis and periappendicitis. Image credit: Michael Bonert / CC BY-SA 3.0.
Appendicitis is widespread among children and young people, and the condition is the most common cause of emergency abdominal surgery in the world.
One third of children affected have a more complicated form of appendicitis which requires a longer hospital stay and sometimes several surgeries. It is not yet clear why some children are affected by this more serious form of appendicitis, nor whether it is possible to prevent it.
One theory holds that complicated appendicitis depends on the body’s immunological response differing to the response in cases of uncomplicated appendicitis.
According to this theory, children with allergies have a lower risk of contracting complicated appendicitis, because their immunological response is different from that of non-allergic children. However, this had not been investigated more closely until now.
“In a study of all the children who underwent surgery for appendicitis in Lund, Sweden, over the span of a decade, we found that the most common form of allergy, such as allergy to pollen and animal fur, was associated with a three times lower risk of developing complicated appendicitis,” said study lead author Dr. Martin Salö, a researcher at Lund University and physician at Skåne University Hospital.
“The lower risk remained when we adjusted for other parameters known to increase the risk of serious appendicitis, such as lower age and long-lasting symptoms.”
The study included all patients younger than 15 years who underwent appendectomy for acute appendicitis at Skåne University Hospital between January 1, 2007, through July 31, 2017. Children were stratified between those with and without IgE-mediated allergies.
Of 605 included children (63% boys; median age – 10 years), 102 (16.9%) had IgE-mediated allergy and 503 (83.1%) had no allergy.
Complicated appendicitis occurred in 20 children with IgE-mediated allergy (19.6%) compared with 236 with no allergy (46.9%). Children with IgE-mediated allergy had a shorter hospital stay.
“The outcome of the study supports the theory that complicated appendicitis has a different immunological development compared to uncomplicated appendicitis,” Dr. Salö said.
“The results also provide clues that we hope can lead to the development of new diagnostic aids such as blood tests.”
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Martin Salö et al. Association of IgE-Mediated Allergy with Risk of Complicated Appendicitis in a Pediatric Population. JAMA Pediatr, published online August 6, 2018; doi: 10.1001/jamapediatrics.2018.1634
