Evaluation of nutritional anemia as a risk factor for childhood allergic diseases

INTRODUCTION: This prospective observational study aimed to evaluate the prevalence of allergic diseases in children with nutritional anemia caused by iron, vitamin B12, or folate deficiencies using clinical assessment tools, including the ISAAC questionnaires, skin prick testing, and laboratory markers.
METHODS: Between July 2013 and February 2014, a total of 123 children aged 3–18 years, including 77 children with anemia and 46 controls, were prospectively evaluated at Zeynep Kamil Women and Children’s Health Training and Research Hospital. The ISAAC questionnaires were administered to determine the frequency of asthma, allergic rhinitis, and atopic dermatitis. Complete blood count, ferritin, serum iron, folic acid, vitamin B12, total IgE, and eosinophil levels were analyzed, and skin prick testing was performed.
RESULTS: Allergic disease was detected in 24.7% of the patient group and 30.4% of the control group. No significant differences were found between the groups in the rates of physician-diagnosed asthma (1.3% vs. 4.3%), allergic rhinitis (22.1% vs. 26.1%), or atopic dermatitis (1.3% vs. 0%) (p>0.05). The frequency of atopy was 15.8% in the patient group and 14.2% in the control group. No differences were found in total IgE or eosinophil levels.
DISCUSSION AND CONCLUSION: Nutritional anemias, including iron deficiency anemia and vitamin B12 and folate deficiencies, were not found to increase the frequency of allergic diseases in children. In line with the current literature, it was concluded that this relationship may be bidirectional (allergic disease → anemia or anemia → atopic severity) and that larger prospective studies are needed.

Keywords: Allergic diseases, atopy, folic acid, iron deficiency anemia, ISAAC, nutritional anemia, skin prick test, vitamin B12.