{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T12:50:05Z","timestamp":1767876605247,"version":"3.49.0"},"reference-count":0,"publisher":"Codon Publications","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergol Immunopathol"],"abstract":"<jats:p>Background: Adult immunoglobulin E (IgE)-mediated food allergy (FA) is increasingly recognized, yet it has remained under-characterized, compared with pediatric FA. We described clinical features, diagnostic profiles, predictors of severe reactions and explored a pragmatic total IgE cut-off in an adult cohort.\nMethod: We retrospectively reviewed 423 consecutive adults evaluated for suspected IgE-mediated FA at a tertiary center. Demographics, comorbid atopy, index culprit foods, diagnostic testing (skin prick\/prick-to-prick, serum-specific IgE, component-resolved diagnostics), laboratory parameters, reaction severity (Brown grade severity), and adrenaline autoinjector (AAI) prescribing were extracted. Group comparisons used \u03c72\/Fisher\u2019s exact,\u00a0t-test, or Mann\u2013Whitney U tests. Receiver operating characteristic analysis assessed the discriminative value of total IgE for confirmed FA. Variables associated with Brown grade 3 severity were examined by multivariable logistic regression.\nResults: FA was confirmed in 79\/423 patients (18.7%). Median age was 39.2 years; 71.4% were females. Frequent implicated groups were meat (23.9%), fruit (23.4%), nuts (22.5%), and vegetables (19.4%). Atopy was present in 46.1%; sensitization to mites and pollens occurred in 38.3% and 25.1%, respectively. Compared to non-confirmed cases, confirmed FA showed higher proportions of asthma, non-steroidal anti-inflammatory drug allergy, moderate\/severe reactions (Brown grades 2\u20133 severity), atopy, mite\/pollen sensitization, latex\u2013fruit and pollen\u2013fruit syndromes, AAI prescription, and food-dependent exercise-induced anaphylaxis (all P &lt; 0.05). Eosinophil count\/percentage and total IgE were also high (all P &lt; 0.05). Total IgE \u2265110.5 IU\/mL predicted confirmed FA with 64.6% sensitivity and 59.7% specificity (area under curve 0.634; 95% confidence interval [CI]: 0.561\u20130.706; P = 0.001). In multivariable analysis, the absence of rhinitis and fish\/seafood allergy, and the presence of atopy were independently associated with Brown grade 3 severity (model accuracy 84.4%). Overall, AAIs were prescribed in 38.1%, more often when FA was confirmed (66.7% vs 31.7%).\nConclusions: Adult FA in a real-world tertiary cohort is clinically heterogeneous and clusters with respiratory atopy. A total IgE threshold of 110.5 IU\/mL offers modest discrimination and should complement, not replace, history and allergen-specific testing. Rhinitis, fish\/seafood allergy, and lack of atopy identify patients at higher risk of severe reactions and may guide risk stratification and AAI prescribing.<\/jats:p>","DOI":"10.15586\/aei.v54i1.1548","type":"journal-article","created":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T14:53:09Z","timestamp":1767279189000},"page":"145-153","source":"Crossref","is-referenced-by-count":0,"title":["Adult IgE-mediated food allergy: clinical characteristics, predictors of severe reactions, and total IgE cut-off"],"prefix":"10.15586","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7068-2842","authenticated-orcid":false,"given":"\u00d6zge","family":"Arg\u0131n","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6858-6824","authenticated-orcid":false,"given":"Zeynep","family":"Yegin Katran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u0130smet","family":"Bulut","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6228","published-online":{"date-parts":[[2026,1,1]]},"container-title":["Allergologia et Immunopathologia"],"original-title":[],"link":[{"URL":"https:\/\/all-imm.com\/index.php\/aei\/article\/download\/1548\/2241","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/all-imm.com\/index.php\/aei\/article\/download\/1548\/2242","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/all-imm.com\/index.php\/aei\/article\/download\/1548\/2243","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/all-imm.com\/index.php\/aei\/article\/download\/1548\/2241","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T10:16:24Z","timestamp":1767867384000},"score":1,"resource":{"primary":{"URL":"https:\/\/all-imm.com\/index.php\/aei\/article\/view\/1548"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,1]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.15586\/aei.v54i1.1548","relation":{},"ISSN":["0301-0546"],"issn-type":[{"value":"0301-0546","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,1]]}}}