Bir Korkunun Anatomisi: Yumurta Alerjisi Olan Çocuklarda Kızamık-Kabakulak-Kızamıkçık Aşılamasının Klinik Sonuçları
Abstract
Amaç: Bu çalışma, kızamık-kabakulak-kızamıkçık (KKK) aşısı sonrası yumurta alerjisi olan çocuklarda alerjik reaksiyonların sıklığını ve klinik özelliklerini değerlendirmeyi amaçlamaktadır. KKK aşısını seçme amacımız, özellikle yumurta alerjisi olan çocuklarda aşıya bağlı alerjik reaksiyonların daha iyi anlaşılması ve güvenilirliğinin değerlendirilmesidir.
Gereç ve Yöntem: 2023-2024 yılları arasında kliniğimizde KKK aşısı yapılan ve yumurta alerjisi tanısı almış 202 hasta üzerinde retrospektif bir analiz gerçekleştirildi. Hastaların demografik, klinik ve laboratuvar verileri incelendi. Yaş, cinsiyet, eşlik eden alerjik hastalıklar, total IgE, süt, yumurta ve kuruyemişlere özgü IgE düzeyleri, deri prick testleri ve aşılama sonrası reaksiyonlar kaydedildi.
Bulgular: Hastaların medyan yaşı 12 ay (dağılım: 7-84 ay) olup, %57,4’ü erkekti. Hastaların %29,2’sinde inek sütü duyarlılığı, %6,9’unda ise kuruyemiş alerjeni duyarlılığı saptandı. En sık görülen klinik durumlar ürtiker (%43,1) ve atopik dermatit (%36,6) idi. Aşılama sonrasında yalnızca dört hastada (%2) lokal döküntü gelişti ve hiçbir hastada anafilaksi öyküsü bulunmadı.
Sonuç: Yumurta alerjisi olan çocuklarda KKK aşısı sonrası ciddi sistemik reaksiyon gözlenmedi. Bulgularımız, mevcut kılavuzları desteklemekte olup, yumurta alerjisi olan çocuklarda KKK aşısının standart koşullar altında güvenle uygulanabileceğini göstermektedir. Çalışmamızda, yumurta alerjisi olan hastaların %29,2’sinde inek sütü alerjisi, %6,9’unda kuruyemiş alerjisi görülmesi çocukluk çağında gıda alerjilerinin sıklıkla bir arada görüldüğünü düşündürmektedir. Ayrıca Türkiye’de kullanılan Hindistan menşeili KKK aşılarının süt proteinleri içerdiği ve bu durumun süt ve yumurta alerjisi olan bireylerde anafilaksi riskini artırabileceği, bu çocuklar aşılanmadan önce aşı prospektüslerinin titizlikle değerlendirilmesi gerektiği vurgulanmaktadır.
References
- Burks AW, Tang M, Sicherer S, Wood R, Assa’ad A, Jones SM, et al. ICON: food allergy. J Allergy Clin Immunol. 2012;129(4):906-920.
- Muraro A, Werfel T, Hoffmann-Sommergruber K, Roberts G, Beyer K, Bindslev-Jensen C, et al. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy. 2014;69(8):1008-1025.
- Sicherer SH, Sampson HA. Food allergy: epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014;133(2):291-307.
- Chafen JJS, Newberry SJ, Riedl MA, Bravata DM, Maglione M, Suttorp MJ, et al. Diagnosing and managing common food allergies: a systematic review. JAMA. 2010;303(18):1848-1856.
- Rona RJ, Keil T, Summers C, Gislason D, Zuidmeer L, Sodergren E, et al. The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol. 2007;120(3):638-646.
- Tedner SG, Asarnoj A, Thulin H, Westman M, Konradsen JR, Nilsson C. Food allergy and hypersensitivity reactions in children and adults: A review. J Intern Med. 2022;291(3):283-302.
- Magistà S, Albanesi M, Chaoul N, Di Bona D, Di Leo E, Nettis E, et al. Safety of measles, mumps, and rubella vaccine in egg allergy: in vivo and in vitro management. Clin Mol Allergy. 2020;18:1-5.
- Urisu A, Kondo Y, Tsuge I. Hen’s egg allergy. Chem Immunol Allergy. 2015;101:124-130.
- Leech SC, Ewan PW, Skypala IJ, Brathwaite N, Erlewyn-Lajeunesse M, Heath S, et al. BSACI 2021 guideline for the management of egg allergy. Clin Exp Allergy. 2021;51(9):1262-1278.
- Dreskin SC, Halsey NA, Kelso JM, Wood RA, Hummell DS, Edwards KM, et al. International Consensus (ICON): allergic reactions to vaccines. World Allergy Organ J. 2016;9:32.
- Cerecedo Carballo I, Dieguez Pastor MC, Bartolomé Zavala B, Sánchez Cano M, de la Hoz Caballer B. Safety of measles-mumps-rubella vaccine (MMR) in patients allergic to eggs. Allergol Immunopathol (Madr). 2007;35(3):105-109.
- Dumortier B, Nosbaum A, Ponvert C, Nicolas JF, Bérard F. Measles-mumps-rubella vaccination of an egg-allergic child sensitized to gelatin. Arch Pediatr. 2013;20(8):867-870.
- Freitas DR, Moura E, Araújo G, Soárez PC, Fernandes EG, Monteiro AM, et al. Investigation of an outbreak of hypersensitivity-type reactions during the 2004 national measles-mumps-rubella vaccination campaign in Brazil. Vaccine. 2013;31(6):950-954.
- Nilsson L, Brockow K, Alm J, Cardona V, Caubet JC, Gomes E, et al. Vaccination and allergy: EAACI position paper, practical aspects. Pediatr Allergy Immunol. 2017;28(7):628-640.
- Yavuz ST, Şahiner UM, Sekerel BE, Tuncer A, Kalaycı O, Sackesen C. Anaphylactic reactions to measles-mumps-rubella vaccine in three children with allergies to hen’s egg and cow’s milk. Acta Paediatr. 2011;100(6):e94-e96.
- Altaş U, Çetemen A, Altaş ZM, Akkelle E, Özkars MY, Doğru M. Experience of measles-mumps-rubella vaccine among children with egg allergy: Measles-mumps-rubella vaccine and egg allergy. The Injector. 2023;2(3):157-162.
- Çiçek F, Köle MT. Evaluation of the impact of serum vitamin D levels on the Scoring Atopic Dermatitis Index in pediatric atopic dermatitis. Children. 2023;10(10):1522.
- Buczyńska A, Grzybowska-Chlebowczyk U, Pawlicki K. IgE-dependent food sensitisation and its role in clinical and laboratory presentation of pediatric inflammatory bowel disease. Nutrients. 2023;15(8):1804.
- Keleş Ş, Filiz S. Evaluation of reaction status following measles-mumps-rubella vaccination in children with egg allergy. Pamukkale Med J. 2020;13(3):687-693.
- Ayçin GD. Prick test results and vaccine reactions before measles-mumps-rubella vaccination in children with egg allergy. Osmangazi Med J. 2020;42(4):378-383.
- Çöğürlü MT, Simsek IE. How necessary is skin testing before measles-mumps-rubella vaccination in children with egg allergy? How safe is the vaccine? Kocaeli Med J. 2019;8(1):220-225.
- Sayar EH. Experience of measles-mumps-rubella vaccination in infants with egg allergy. Acta Med Alanya. 2019;3(3):283-286.
- Özdemir Ö, Ersavaş D. Measles, measles-mumps-rubella (MMR), and varicella vaccinations in children with egg allergy. J Acad Res Med. 2017;7(2):42-45.
An Anatomy of a Fear: Clinical Outcomes of Measles-Mumps-Rubella Vaccination in Children with Egg Allergy
Abstract
Objective: This study aimed to evaluate the frequency and clinical characteristics of allergic reactions following Measles-Mumps-Rubella (MMR) vaccination in children with egg allergy. Our aim in selecting the MMR vaccine was to better understand vaccine-related allergic reactions in children with egg allergy and to assess its reliability.
Material and Method: A retrospective analysis was conducted on 202 patients diagnosed with egg allergy who received the MMR vaccine in our clinic between 2023 and 2024. Demographic, clinical, and laboratory data were reviewed. Patients’ age, sex, concomitant allergic diseases, total IgE, specific IgE for milk, egg, and nuts, skin prick tests, and post-vaccination reactions were recorded.
Results: The median age of the patients was 12 months (range: 7-84 months), and 57.4% were male. Sensitization to cow’s milk was detected in 29.2% of the patients, while 6.9% had nut allergen sensitivity. The most common clinical conditions were urticaria (43.1%) and atopic dermatitis (36.6%). Following vaccination, only four patients (2%) developed localized rash, and none had a history of anaphylaxis.
Conclusion: No severe systemic reactions were observed following MMR vaccination in children with egg allergy. Our findings support current guidelines, suggesting that MMR vaccination can be safely administered under standard conditions in children with egg allergy. In our study, 29.2% of patients with egg allergy had cow’s milk allergy, and 6.9% had nut allergy, suggesting that food allergies are often seen together in childhood. Additionally, it is emphasized that the India-made MMR vaccines used in Turkey contain milk proteins, which may increase the risk of anaphylaxis in individuals with milk and egg allergies, highlighting the need for careful evaluation of the vaccine prospectus before vaccination in these children.
References
- Burks AW, Tang M, Sicherer S, Wood R, Assa’ad A, Jones SM, et al. ICON: food allergy. J Allergy Clin Immunol. 2012;129(4):906-920.
- Muraro A, Werfel T, Hoffmann-Sommergruber K, Roberts G, Beyer K, Bindslev-Jensen C, et al. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy. 2014;69(8):1008-1025.
- Sicherer SH, Sampson HA. Food allergy: epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014;133(2):291-307.
- Chafen JJS, Newberry SJ, Riedl MA, Bravata DM, Maglione M, Suttorp MJ, et al. Diagnosing and managing common food allergies: a systematic review. JAMA. 2010;303(18):1848-1856.
- Rona RJ, Keil T, Summers C, Gislason D, Zuidmeer L, Sodergren E, et al. The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol. 2007;120(3):638-646.
- Tedner SG, Asarnoj A, Thulin H, Westman M, Konradsen JR, Nilsson C. Food allergy and hypersensitivity reactions in children and adults: A review. J Intern Med. 2022;291(3):283-302.
- Magistà S, Albanesi M, Chaoul N, Di Bona D, Di Leo E, Nettis E, et al. Safety of measles, mumps, and rubella vaccine in egg allergy: in vivo and in vitro management. Clin Mol Allergy. 2020;18:1-5.
- Urisu A, Kondo Y, Tsuge I. Hen’s egg allergy. Chem Immunol Allergy. 2015;101:124-130.
- Leech SC, Ewan PW, Skypala IJ, Brathwaite N, Erlewyn-Lajeunesse M, Heath S, et al. BSACI 2021 guideline for the management of egg allergy. Clin Exp Allergy. 2021;51(9):1262-1278.
- Dreskin SC, Halsey NA, Kelso JM, Wood RA, Hummell DS, Edwards KM, et al. International Consensus (ICON): allergic reactions to vaccines. World Allergy Organ J. 2016;9:32.
- Cerecedo Carballo I, Dieguez Pastor MC, Bartolomé Zavala B, Sánchez Cano M, de la Hoz Caballer B. Safety of measles-mumps-rubella vaccine (MMR) in patients allergic to eggs. Allergol Immunopathol (Madr). 2007;35(3):105-109.
- Dumortier B, Nosbaum A, Ponvert C, Nicolas JF, Bérard F. Measles-mumps-rubella vaccination of an egg-allergic child sensitized to gelatin. Arch Pediatr. 2013;20(8):867-870.
- Freitas DR, Moura E, Araújo G, Soárez PC, Fernandes EG, Monteiro AM, et al. Investigation of an outbreak of hypersensitivity-type reactions during the 2004 national measles-mumps-rubella vaccination campaign in Brazil. Vaccine. 2013;31(6):950-954.
- Nilsson L, Brockow K, Alm J, Cardona V, Caubet JC, Gomes E, et al. Vaccination and allergy: EAACI position paper, practical aspects. Pediatr Allergy Immunol. 2017;28(7):628-640.
- Yavuz ST, Şahiner UM, Sekerel BE, Tuncer A, Kalaycı O, Sackesen C. Anaphylactic reactions to measles-mumps-rubella vaccine in three children with allergies to hen’s egg and cow’s milk. Acta Paediatr. 2011;100(6):e94-e96.
- Altaş U, Çetemen A, Altaş ZM, Akkelle E, Özkars MY, Doğru M. Experience of measles-mumps-rubella vaccine among children with egg allergy: Measles-mumps-rubella vaccine and egg allergy. The Injector. 2023;2(3):157-162.
- Çiçek F, Köle MT. Evaluation of the impact of serum vitamin D levels on the Scoring Atopic Dermatitis Index in pediatric atopic dermatitis. Children. 2023;10(10):1522.
- Buczyńska A, Grzybowska-Chlebowczyk U, Pawlicki K. IgE-dependent food sensitisation and its role in clinical and laboratory presentation of pediatric inflammatory bowel disease. Nutrients. 2023;15(8):1804.
- Keleş Ş, Filiz S. Evaluation of reaction status following measles-mumps-rubella vaccination in children with egg allergy. Pamukkale Med J. 2020;13(3):687-693.
- Ayçin GD. Prick test results and vaccine reactions before measles-mumps-rubella vaccination in children with egg allergy. Osmangazi Med J. 2020;42(4):378-383.
- Çöğürlü MT, Simsek IE. How necessary is skin testing before measles-mumps-rubella vaccination in children with egg allergy? How safe is the vaccine? Kocaeli Med J. 2019;8(1):220-225.
- Sayar EH. Experience of measles-mumps-rubella vaccination in infants with egg allergy. Acta Med Alanya. 2019;3(3):283-286.
- Özdemir Ö, Ersavaş D. Measles, measles-mumps-rubella (MMR), and varicella vaccinations in children with egg allergy. J Acad Res Med. 2017;7(2):42-45.
Details
| Primary Language | English |
|---|---|
| Subjects | Allergy |
| Journal Section | Research Articles |
| Authors | |
| Early Pub Date | July 17, 2025 |
| Publication Date | July 21, 2025 |
| Submission Date | February 24, 2025 |
| Acceptance Date | April 11, 2025 |
| Published in Issue | Year 2025 Volume: 7 Issue: 2 |
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